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PRACTICAL GUIDE 

TO THE 

MANAGEMENT 

OF THE 

TEETH; 

COMPRISING 

A DISCOVERY OF THE ORIGIN OF CARIES, 

OR 

DECAY OF THE TEETH; 

WITH ITS PREVENTION AND CURB. 



BY L. S. PARMLY, 

DENTAL PROFESSOR. 



" The great distress which usually accompanies, and 
the inconvenience which always follows the loss of the 
Teeth, makes the discovery of same mode of prevention 
of caries very desirable." Fox. 



PHILADELPHIA: 
PUBLISHED BY COLLINS 8c CROFT, 

NO. 73, MARKET STREET. 
J. R, A. Skerrett, Printer. 



-WVWX- 



1819. 



To BENJAMIN WEST, Esq. 

^-President of the Royal Academy of Jlrts 9 
$c. Sfc. $c. 



DEAR SIR, 

In addressing this small performance 
to you, my intention is less to congratu- 
late you on the fame your unrivalled ta- 
lents have secured to you in a depart- 
ment of the Arts, demanding all the finer 
powers of taste and genius, than to mark 
my high esteem for your private charac- 
ter as a man, in which the union of those 
virtues that diffuse happiness in the va- 
rious relations of domestic life are so 
eminently conspicuous. 

I have the honour to be, 
Dear Sir, 
Your very obliged 

humble Servant, 

X. S. PARMXY, 



BUCKINGHAM STREET, 

ADELPHI. 



CONTENTS. 



PAGE 

Dedication . ..... iii 

Introduction 3 

General view of the body .... 21 

Formation and structure of the teeth . . 44 

Shedding of the teeth .... 60 

The adult teeth 66 

Diseased teeth and gums .... 74 

Caries 76 

Tartar 86 

Tooth-ache • 91 

Occasional effects of diseased teeth . . 96 

Structure of the gums . ... . 100 

Structure of the alveolar processes . . 106 

Management of the teeth . . . Ill 

OPERATIONS ON THE TEETH. 

Scaling 123 

Extraction 127 

Mending or capping diseased teeth . . 132 

Artificial teeth 135 

Transplanting of teeth .... 142 

Irregularities of the teeth .... 145 

Fractures of the teeth .... 151 

Cracks of the enamel 155 

Denuding process 157 

Wearing of the teeth 159 

Morbid growth cf the gums . . . 161 

Artificial palates 165 

Ligatures of the teeth .... 167 

Antrum Maxillare ..... 170 

Physiognomy of the teeth . . . 174 
Domestic Advice - . . . .183 



PREFACE. 



In submitting the following sheets to 
the attention of the Public, the Author 
feels it necessary to apologize for occa- 
sional inaccuracies of style \ which the 
circumstance of his being a foreigner, 
combined with his anxious desire and 
impatience to make known some import- 
ant discoveries, has rendered it as diffi- 
cult for him to avoid, as it has afforded 
him but little leisure to correct. 

The teefrh, it is well known, are or- 
gans most important to the animal eco- 
nomy. Their use in conveying distinct 
articulation, in ministering to the com- 
fort, or promoting the health, of the in- 
dividual, is too obvious to be insisted on. 
Suffice it to observe, that when, from 
disease or accident, impediments arise 
to the discharge of their proper func- 
tions, calamities most mischievous to the 

A 2 



PREFACE. 

system ensue : every medical man know- 
ing that imperfect mastication is a fruit- 
ful cause of many disorders the most 
distressing, dangerous, and even fatal 
to the human frame. Numerous have 
been the publications of able and skilful 
men, who have preceded the Author in 
this path of science. It is however me- 
lancholy to reflect how little that is 
really useful, has accrued from their la- 
bours. Experience evinces that all their 
instructions are but ill adapted to an- 
swer the intended purpose. Diseased 
gums, offensive breath, deficient and de- 
cayed teeth, are still objects of public 
notoriety. Conscious therefore how 
much remained to be accomplished, in 
every thing relating to the management 
of the teeth, the Author was induced to 
direct his attention very early to the 
subject: and the result of many years 
close application and study, has been at- 
tended by a discovery the most import- 
ant that has yet been made in this branch 



[PREFACE. 

of physiology. Regulating his practice 
by the principles of his own system, he 
has now the pleasure of announcing to 
the public, the signal success that has 
marked his professional career in vari- 
ous parts of the world, and more parti- 
cularly in this metropolis. Testimonies, 
as numerous as they are highly respecta- 
ble, will satisfy the most incredulous, 
that these are not the pretensions of an 
empyric, and will convince those desir- 
ous of placing themselves under his care, 
of the decided superiority of his mode of 
treatment in every possible case of dis- 
eased dentition, and under every variety 
of age, constitution, and habit of his pa- 
tients. He also undertakes to initiate 
the youth of both sexes, without any la- 
borious process, in the dental art, so 
as to enable them to preserve these im- 
portant organs in a perfectly sound and 
healthful state, to the most protracted 
period of life. 



PHEFACE. 

Wherever, in the following work, the 
Author has ventured to criticise either 
the opinions or practice of his prede- 
cessors, he can truly say, he has been 
influenced by no other motives, than a 
wish to promote the improvement of an 
art but too little studied, and to excite 
the attention of the public, and the minds 
of professional men in particular, to its 
importance. Where their sentiments ap- 
peared founded on just observation, he 
has willingly adopted them, and in do- 
ing so, he has not scrupled occasionally 
to borrow their language. Should what 
he has written, have the effect of rescu- 
ing only one individual from the suffer- 
ings incident to a neglect of the teeth, 
lie will not regret the time the present 
publication has cost him. 

Buckingham Street, Melphi. 



DESCRIPTION OF THE PLATE. 



Figure 1. Rabbit Mouth. 

2. Toothless Mouth. 

3. Projecting Chin. 

4. Mouth, without any deformity. 

Number 5. Mouth, expanded to shew all the teeth. 

No. 1. 1. Front Incisores, *) 

V or Cutting* Teeth, 

2. 2. Lateral Incisores, J 

3. 3. Cuapidati, Canine, or Eye Teeth. 

4. 4. 4. 4. Two pair of Bicuspides, or small Grin- 
ders. 
5. 5. 5. 5. Molares, or large Grinders. 

6. 6. Denies Sapientix, or Wisdom Teeth, 



INTRODUCTION. 



THE division of surgery into various 
branches, has, in a particular manner, served 
to promote the advancement of the science, 
and thereby been productive of the happiest 
benefits to society. 

In examining the progress of the improve- 
ments in its different branches, it is to be 
observed with regret, that the Dental Art 
has not kept pace with many others of less 
real utility. One cause of this slow pro- 
gress of dental science is, that the subject 
has not hitherto been considered as forming 
an essential part of professional education. 
Hence, the practice of it has generally been 
considered in no higher light than a mecha- 



IV 



nical occupation or trade. A great improve- 
ment of this department of surgery, will de- 
pend on pointing out to society the import- 
ance of preventing diseases of the Teeth ; 
and their connexion, in almost every instance, 
with the general state of the health, and pre- 
servation of the system. 

Nothing can tend so much to accomplish 
this object, as an institution for the exclusive 
promotion of dentalogical science. The 
wants of society, as well as the disposition of 
the present enlightened period, so favoura- 
ble to the universal diffusion of knowledge, 
demand such an institution; and such, we 
flatter ourselves, we are authorised shortly 
to anticipate, when this noble art will be 
rescued from that degraded state in which it 
has long remained in the hands of ignorant 
practitioners, or mercenary pretenders, who 
have in a great degree made it a monopoly. 
Within these few years, it must be admitted, 
that some attempts have been made at im- 
provement; and the publication of the late 
Mr. Fox, joined with his regular course of 
•lectures on this branch of physiology, has 



done more for its promotion than the labours 
of any other individual, though occasionally 
some important errors occur, which it will 
be one object of the present treatise to no- 
tice and correct. 

When we advert to the progress of medical 
and surgical science, during the last few 
years, we are struck with the rapid and 
beneficial changes which have taken place. 

Medicine is now built on experimental 
science, and conducted by those enlightened 
principles which are the fruits of liberal edu- 
cation, and the peculiar spirit of the present 
times. The consequence of this has been, 
that the prejudices of the nurse, the mysteries 
of the empyric, and the pedantry of the 
schools, are completely done away. 

In surgery, the same fortunate improve- 
ment is conspicuous ; the complicated prac- 
tice of former times now yields to a mild and 
natural proceeding: and such is the ad- 
vancement of this branch, that operations 
are daily performed of that bold and deci- 
sive nature, that at a former period, would 

B 



VI 



have been deemed impracticable, and beyond 
the power of art to accomplish. 

This general state of improvement in sur- 
gery gives great encouragement to the ex- 
tention of the dental art. — Were mankind 
sufficiently acquainted with the many dis- 
eases and painful afflictions which originate 
from want of attention to cleanliness of the 
mouth; and were they convinced, that, from 
this cause alone, numbers drag out a life of 
distress, they would feel a greater curiosity, 
and take a more lively interest in obtain- 
ing information respecting an art, which the 
considerations of appearance, comfort, and 
health, render so essential. That such an in- 
terest has not been felt is the more astonish- 
ing, since we cannot but observe how anxi- 
ously solicitous the mind daily discovers 
itself to be on subjects of less importance* In- 
deed, mankind, in general, are not sufficient- 
ly impressed with the utility of improve- 
ments, till their own feelings convince them 
of their necessity. In the present instance, 
the truth of this observation is but too obvi- 
ous; for, in most cases, it is either the loss 



VIJ 



of Teeth, or the sensation of pain that in- 
duces people to pay attention to cleanliness 
of the mouth. 

Though, at every time of life, an attention 
to the teeth is necessary, for their appearance 
and preservation ; yet there are certain criti- 
cal periods at which we are irresistibly led 
to the contemplation of the subject. — In- 
fancy is one of them: when the teeth suc- 
cessively appear, the constitution of the child 
suffers from their protrusive power, and a 
general irritative action pervades the system; 
the sleep is disturbed, the appetite suffers, the 
bowels are deranged, the muscular flesh de- 
cays, and marks of universal sympathy affect 
every part. The anxious day and watchful 
night then give importance, in the opinion 
of mothers and female attendants, to this 
part of the human structure; and it is then 
that the greatest mortality of infancy occurs. 
It is computed, that no less than one-fourth 
of the human race die under two years of age, 
and it is clearly connected with this source; 
for the enlarged state of the nervous and 
vascular system gives a predisposition, at this 



Till 

dawn of life* to inflammation and disease 
from the slightest causes. The next period 
that calls the attention to the teeth, is the 
time of shedding the temporary set. The 
habit now more firm, does not suffer the 
same general uneasiness as at the former pe- 
riod: but the process of nature, often imper- 
fectly performed in the removal of the origi- 
nal set. requires to be assisted, in order to 
prevent that local deformity or disfiguration 
of countenance and features, winch is well 
known to arise from tins cause. Hence, 
this is a period to be earnestly watched bj 
parents and guardians, especially when en- 
trusted with the care of females, if personal 
advantages are to be studied and a pleasing 
exterior preserved. The last period of par- 
ticular attention to the teeth is, when they 
begin to decay; for not only do they give ex- 
quisite pain, as the feeling of tooth-ache con- 
vinces, but the cause which moulders them 
away, like other species of gangrene, affects 
the contiguous parts, taints the breath, and 
causes the fetor of the mouth to be disagree- 
ablej even to the individual himself. Thus 



IX 



daily experience proves, that the teeth are 
generally the subject of pain and disease; 
and the question to be considered is. whether 
this state be naturally entailed upon them, or 
results from our own imprudence and neglect. 

From the moment that the teeth have pro- 
truded, and appear in their proper situation, 
they are liable to be acted upon by every ar- 
ticle of aliment that remains upon them : to 
protect them against this action, they are 
covered with an exterior coat, termed the Cor- 
tejc Striatas, or enamel, different from other 
bone, and the structure of which constitutes 
their ornament as well as their defence. — 
While a strict attention is paid to cleanli- 
ness of the mouth, this enamel will be a suf- 
ficient protection against the operations of 
every external cause. 

The teeth of the savage are generally 
sound and regular, and no accumulation 
forms to deface them. But this is different 
in civilized society; refinements in the culi- 
nary art give the food a greater tendency to 
acquire noxious powers, and form chemical 
combination. 

b2 



This is displayed by the formation of that 
extraneous matter, called tartar, which, as it 
accumulates, seperates the teeth from their 
chief support, the investing membrane of the 
gums, and thus loosening them in their sock- 
ets, exposes them, and produces inflamma- 
tion. 

But a more active cause of the premature 
loss of the teeth, is the accumulation or lodg- 
ment of food in their interstices. There the 
putrefactive process commences, acts upon 
the enamel and penetrates to the bone.* In 
this way the tooth becomes gradually des- 
troyed, and the individual suffers successive 
inflammation and pain for a time, till this 
active monitor, that leads to attention in all 



* The Author is aware, that most of his prede- 
cessors who have written on this subject, and 
among the rest, the celebrated Mr. Fox, have given 
a different Theory of Caries, supposing that it com- 
mences in the internal part of the tooth, and at 
length extends its ravages to the enamel. 

For further information, however, on this subject^ 
the reader is referred to the chapter ,on Caries. 



cases, speaks in a language not to be misun- 
derstood, tlie mischief of neglect. 

If cleanliness be essential to other parts 
of the body, it is peculiarly necessary with 
respect to the mouth, through which is the 
opening for carrying on the two great pro- 
cesses essential to continuance of animal life: 
the process of digestion, which gives nourish- 
ment and support to the system ; and the 
process of breathing, which conveys a princi- 
ple from the air connected with vitality. If, 
then, the food, from uncleaniiness of the 
mouth, be tainted in the preparatory step of 
mastication, the process of digestion must in- 
troduce into the system a tainted chyle, preg- 
nant with the seeds of putrefaction : if the 
air inhaled receive the same impregnation* 
which is the opinion of some of the most 
skilful of the faculty, it cannot animate the 
body or give vital energy in a proper degree. 
These effects, which are independent of its 
injury to the teeth, have never been sufficient- 
ly appreciated. Thus, in all cases of unclean 
teeth, a putrid matter is daily passing into 
the body, and acting as a slow and unseen 



xn 

poison for months and years, on every part 
of the frame. When this is reflected on, 
can there be a stronger inducement to clean 
the teeth in a regular and proper manner, as 
a preventive of general disease ? 

The more we examine the structure of the 
human body, however varied and multiplied 
its parts, the more we are struck with the in- 
timate connexion of each part with the whole. 
Numerous as they are, to each is assigned 
some peculiar and needful office, and in a 
healthy state, the most perfect harmony sub- 
sists between them ; no one obstructs, but 
each assists, the operation of the other, and 
thus promotes the ultimate preservation of 
the whole. By this wise adjustment, there 
is no schism in the body, no separate or in- 
terfering ends are pursued by the multiplicity 
of members, but the safety and support of 
each are the undivided care of all. Hence, 
in this view, there is no part of the frame 
that is not of importance, however trifling or 
insignificant it may appear ; the most vital, 
as well as those on which the lesser energies 



Xlll 

of the system depend, are equally essential 
to life and its comforts. 

On these considerations, the teeth certain- 
ly claim an important rank in the human 
structure: for — 

1st. On them depends the proper expres- 
sion of the countenance. By their removal 
the character and symmetry of the face is 
lost, and beauty is thus deprived of its chief 
attraction. The celebrated Lavater has paid 
particular attention to this subject in his 
work, and pointed out their effect and im- 
portance in delineating the features of the 
mind. From this effect on the features they 
call for more particular attention on the part 
of females ; for (to use a quaint expression) 
no woman can be beautiful " in spite of her 
teeth y- and when the mouth is deprived of 
this ornament, the countenance loses its 
principal charm. 

2ndly. To the teeth also is assigned the 
chief power of enunciation. If the great and 
pre-eminent prerogative of man is the pos- 
session of speech, that speech can never be 
complete or perfect, without the teeth to mo- 



XIV 

dulate the sound, and give proper utterance 
to the words. Hence, when the teeth are 
lost, the speech becomes imperfect and 
scarcely understood. This circumstance 
gives them additional value, particularly to a 
man in public life 5 and the preservation of 
the teeth ought to be one of the first objects 
to those who wish to shine either in the se- 
nate, at the bar, or in the pulpit. Without 
these instruments of utterance, the graces of 
their eloquence are lost, and the power of af- 
fecting the mind and convincing the under- 
standing, if n6t taken away, is considerably 
diminished. 

3dly. It is the loss of this part of the 
structure, that produces the leading mark of 
age, and occasions the contracted counte- 
nance, the wrinkles of the face, and those 
unseemly changes which youth and beauty 
ever wish to see placed at a distance. 

4thly. When the teeth are neglected, they 
frequently assume a preternatural growth, 
which produces a disagreeable change on the 
countenance ; and this, of itself, should be a 
sufficient inducement to their frequent in- 



XV 



spection, where external appearance is con- 
sidered of any importance. 

Jthly. But the most dangerous effect of 
neglect of the teeth, and their consequent 
Joss, is the imperfect mastication of the food, 
which occasions indigestion, and a variety of 
disorders depending on this cause. In order 
to a proper digestion, it is necessary that the 
food be sufficiently comminuted by the action 
of the teeth, while, during this action* it be- 
comes blended with a certain quantity of 
saliva; thus' rendering its solution easier 
when it descends into the stomach to be mix- 
ed with the gastric juice. Where the teeth 
are wanting, the food can neither be proper- 
ly divided or broken down, nor a due quanti- 
ty of saliva elicited from the glands, to ren- 
der its solution in the stomach complete for 
forming it into perfect chyle. 

6thly, A disagreeable, though not a dan- 
gerous, effect from the neglect of the teeth. 
is an offensive breath : this fact is suscepti- 
ble of demonstration by positive experi- 
ments, one is, that the breath, which is exhal- 
ed by the nostrils, is widely different from 



XVI 

that which ia expired through the mouth of 
a person with diseased teeth and gums; foetid 
breath therefore is confined entirely to the 
state of the mouth, and has no connexion 
with that of the stomach, or the digestive or- 
gans, as is erroneously supposed :— eructa- 
tation or belching can only produce a tem- 
porary effect ; but, from uncleanliness of the 
mouth, we find the taint constant and habi- 
tual ; and, unless the cause be eradicated, all 
the spices and perfumes of the east, though 
they may conceal, cannot remove it. 

7thly. Besides the reasons already assign- 
ed, for the necessity of a strict attention to 
the teeth and gums, may be added their 
great influence on the state of the general 
health. 

The danger to the lungs from constantly 
inhaling a putrid effluvium, has been strong- 
ly commented upon by the faculty, as a 
leading cause of pulmonary consumption. 
When the great annual mortality from this 
disease is considered, we cannot doubt that 
this putrid matter may so change the nature 
of the fluid inhaled, as to cause that slow in- 



XVII 

flammation of tlie lungs, productive of those 
tubercles which are the foundation of the dis- 
ease. 

The teeth may be considered, in some 
measure, as extraneous bodies ; and thus do 
not, like the other parts of the human frame. 
possess the power of freeing themselves from 
whatever is injurious. The importance 
therefore of an acquaintance with the den- 
tal art, as a part of education appears indis- 
pensable, is the only means by which this de- 
partment of science can be enabled to take 
that rank, which its importance in promoting 
the health and comfort of mankind so impe- 
riously demands. Nothing will be a source 
of greater satisfaction to the author, than that 
his humble efforts should be instrumental in 
effecting so desirable a purpose, by impress- 
ing on the minds of parents and guardians, 
the necessity of the care and management of 
the teeth as a primary duty, with a view to 
the entire prevention of dental disease and 
deformity. If begun in childhood, and con- 
tinued in the regular manner recommended, 
no accumulation could be formed. — The pre- 



XV111 

vention of dental disease is founded on an 
important discovery of the author: expe- 
rience has satisfied him fully of its success; 
and this experience makes him more eager 
to impress the same conviction on others. 
If to vaccination we owe, of late years, a 
decrease of the annual mortality, a point 
clearly proved, the prevention of dental 
disease will add to this decrease ; for the 
constitution will not be worn out, and the 
health impaired, by sleepless nights and 
days of tormenting pain from dental irrita- 
tion, as happens to too many who date the 
first symptoms of their ill -health from this 
cause. 

It has been a common opinion, that the 
teeth are intended by nature to decay sooner 
than the other parts ; but this opinion is erro- 
neous. Their premature decay is the con- 
sequence of neglect ; and neglect acts here 
in the same manner as in other cases, by 
sapping the vital energy of the part, if we 
may use the expression, and thus occasioning 
them to moulder awav. 



XIX 

After these observations on the importance 
of the care of the teeth, and as a preliminary 
to the present work, it may be proper to take 
a general view of the organized structure of 
man. 



A 

GENERAL VIEW 

OF THE 

BODY. 



THE body is composed of a solid and 
fluid part, mutually dependent on each 
other : the former gives it stability, form, 
and the powers of action ; the latter sup- 
plies the waste, which the solid parts 
necessarily undergo in the prosecution 
of their functions. 

The solid part has been divided by 
anatomists into the head, chest, abdomen, 
and extremities : the first contains that 
organ, — the brain, which is the origin 
and seat of life and feeling; it is en- 
closed in a case of bone for its greater 
defence and security, and is thus equally 
c 2 



screened from heat and defended from 
cold. This part is further covered and 
beautified by an extensive and constant 
growth of hair; and to the most promi- 
nent part of it, the face, is assigned the 
situation of the different senses which 
guide and regulate the actions of the 
body. The chest contains the principal 
organs which give to the nourishment 
the peculiar changes that make it pass 
from a fluid to a solid state, and convert 
it to supply the decay of the solid parts : 
of these organs, the principal are the 
heart, the lungs, and the liver. 

The heart is that strong, indefatigable 
muscle, by which the blood or vital 
stream is conveyed to every part; it is 
enclosed in a membranous bag, the inner 
surface of which is lubricated by a thin 
exhalation to allow it its proper play : it 
possesses two separate cavities. Each 
cavity contains an auricle and a ventri- 
cle. — From the right ventricle the blood 
passes into the lungs by means of the 



33 

pulmonary arteries, and is again return- 
ed to the left cavity of the heart by the 
pulmonary veins. From the left cavity 
it passes into the aorta, to be transmit- 
ted to every part of the system j after 
this, it is received into the cava, and re- 
turned to the heart to undergo the same 
process. Thus, the blood constantly cir- 
culates in an interchangeable tide, whe- 
ther asleep or awake, and knows no in- 
termission in its flow. Through the ar- 
teries it sallies briskly, and returns more 
slowly through the veins. The action 
of the arteries evolves the heat received 
by the lungs, and contained in the blood 
for the animation of the body : this heat 
we find increased by whatever augments 
the velocity of the circulation, and les- 
sened by 'whatever renders it languid. 

The lungs, the next important organ, 
receives the blood from the heart, to 
draw a new principle through them from 
the air, and to return this principle into 



24 

the circulation, to be dispersed to every 
part, conveying increased animation and 
life : they consist of two divisions, one 
on each side the chest, and they open to 
the throat by the trachea, or wind-pipe. 

The liver, the largest gland of the 
body, is situated in the abdomen. Through 
this gland all the blood circulates, in its 
return to the heart, after that principle 
is expended, which it receives from the 
lungs. This organ secretes a peculiar 
fluid, the bile, of great use in the animal 
economy ; and often, by its accumula- 
tion, its deficiency, or obstruction, is the 
source of numerous and serious maladies. 
The gall-bladder is appended to it as 
the reservoir of that secretion. 

Besides these, some of the lesser or 
secondary organs may be notited. The 
kidneys, two small glands situated be- 
tween the back and loins ; the spleen, 
for forming the red globules of the blood, 
or some other important use $ and the 



25 

pancreas, secreting that fluid, termed 
saliva, which assists mastication, and 
moistens the mouth. 

These divisions of the body are cover- 
ed partly with bones and cartilage, form- 
ing a regular arch, gently moveable in 
respiration, which protects the chest, 
and partly with a fine membrane, the 
omentum, and with muscles, which en- 
close the contents of the abdomen: these 
parts are appended to the back bone, 
which sustains the weight of the whole 
structure, and serves also to form a con- 
veyance to that elongation of the brain 
termed the spinal marrow, which gives 
out part of those fine cords or nervous 
filaments, that give sensibility to the 
system. 

The last division of the body is the 
extremities, — the arms, the hands, the 
thighs, the legs, and feet. The arms are 
pendent on either side, proportioned to 
each other, being the guards which de- 



26 

lend, and agents which serve, the whole 
frame; fitted, by their shape and struc- 
ture, for the most diversified and exten- 
sive operations, and capable of perform- 
ing, with singular expedition and ease, 
all manner of useful motions. 

The hands consist of numberless small 
bones and muscles, forming a nice and 
varied mechanism, capable of assuming 
many shapes, and performing every use- 
ful service. 

The lower extremities show the same 
peculiar adjustment of structure for the 
office intended by them. The thighs and 
legs are articulated in such a manner, 
that they administer most commodiously 
to the act of walking, and do not ob- 
struct the easy posture of sitting. By as- 
suming a gentle projection, they under- 
go a diminution of bulk, and acquire a 
more graceful form. 

The feet, the last part of the extre- 
mities, compose a firm and neat pedestal, 
far beyond what statuary or architec- 



87 

ture can ever accomplish. This pedes* 
tal is capable of altering its form, and 
extending its size, as different circum- 
stances require. It contains a set of 
active springs, which tend to place the 
body in a variety of graceful attitudes, 
and qualify it for a multiplicity of ad- 
vantageous motions. The undermost 
parts of the feet are covered with a 
sinewy substance, preventing that undue 
compression of the vessels which the 
weight of the body, in standing or 
walking, might otherwise occasion. 

Such are the four principal divisions 
of the body ; but a part of the structure 
we have hitherto omitted : it is the one 
by which the aliment is received and 
prepared for being introduced into the 
body, to supply the waste that daily and 
hourly takes place. 

This part begins with the mouth ; con- 
taining, first, the teeth set in alveolar 
processes formed on the jaw-bones : the 
upper jaw consists of six pair of bones, 



and one without a fellow, viz. ossamax- 
illaria, ossa malarum, ossa nasi, ossa 
lacrymalia, ossa spongiosa inferivra, and 
ossa palati ; of each of these there are 
two: the thirteenth is a single bone 
called the vomer. 

Ossa maxillaria.~- -These bones con- 
stitute the greater part of the upper 
jaw, of the nose, and of the roof of the 
mouth. They have many processes and 
depressions, which render their figure 
extremely irregular; by the union of 
which, and other bones, are formed the 
cavities called the maxillary sinuses. 
These cavities are situated beneath the 
cheek-bones, and are lined with a con- 
tinuation of the fine membrane which 
lines the cavities of the nostrils and 
frontal sinus : this membrane is called 
the Schneiderian, from the name of its 
discoverer; and upon it the olfactory 
nerves are distributed. The upper sides 
of the maxillary bones form the lower 
and internal circumference of the or- 



29 

bits ; and in their lower sides are the 
sockets for the teeth. They have several 
holes for the admission of nerves and 
vessels ; the principal of which, are the 
foramen orbit ale externum 9 the foramen 
incisivum, and the posterior palatine 
foramen^ which admits the maxillary 
nerve to pass to the teeth. These bones 
are joined to the os frontis and ossa la- 
erijmalia at the great angles of the eyes, 
and to each other under the upper lip. 

Ossa malarum. — These are the pro- 
minent bones which form the cheeks : 
their figure is nearly quadrangular; 
they jnin the os frontis at the little an- 
gles of the eyes, their upper sides form- 
ing the lower and external circumference 
of the orbits. They are smooth and 
convex on the surface, and unequal and 
concave within. The internal sides join 
the ossa maxularia ; and the external 
sides are joined by long processes to the 
temporal bones, which union forms an 
arch called the zygoma. 



so 

Ossa nasi. — So named from their situ- 
ation and use, forming the upper part or 
bridge of the nose : they are thin bones, 
of an irregular, oblong, square figure, 
externally convex and smooth, and in- 
ternally concave and rough. They are 
joined above to the frontal bone — below, 
to the cartilages of the nose — behind, to 
the maxillary bones — in front, to each 
other — and are supported internally by 
the partition between the nostrils, called 
the septum narium. 

Ossa unguis, or lacrymalia. — These 
bones bear some resemblance to the 
finger nail; from whence their name 
unguis : they are also called lacrymalia, 
from the water of the eye passing over 
them into the nose. Their situation is in 
the great angles of the eye, separating 
the orbit from the cavity of the nose. 
Their surface, next the eye, is concave, 
and forms part of the orbit on which 
the eye-ball moves. They join above 
with the os frontis — below, with the 



31 

maxillary bones- — and, internally, with 
the ethmeid bone. 

Ossa spongiosa inferiora, are so called 
from their spongy texture. — These bones 
form part of the nose, enlarge the sur- 
face, and extend the organ of smelling; 
they also assist in forming the under 
part of the lacrymal duct, the orifices 
of which into the nose are concealed by 
them. 

Ossa palati are bones of a very irre- 
gular figure. — They form part of the roof 
of the mouth, of the nose, and of the 
orbits. The portions which form part 
of the palate are irregularly square and 
concave; and, though thin, are firm 
and strong : — they have many pro- 
cesses which joins the other bones of the 
face. 

The vomer has its name from the re- 
semblance it bears to the ancient plough- 
share : its situation is in the middle of 
the lower part of the nose, of which it 
forms the partition. This bone is smooth, 



32 

thin, and of a solid substance ; it en- 
larges the organ of smelling, by allow- 
ing space for expanding the membrane 
of the nose. 

The lower jaw is admirably adapted to 
the necessity which exists for a great va- 
riety of motions, combined with strength 
of action; it is, at first, composed of 
two bones, — the ossific fibres of which 
unite with each other at the chin, soon 
after birth, and, by complete ossifica- 
cation, become one bone ; this union is 
called symphysis. 

This jaw is formed of two lamince, 
whose surface is hard and smooth ; its 
internal substance is cellular : its base 
thick, compact, and hard, particularly 
at the chin, where it is most exposed to 
injury. It has two processes on each 
side ; the anterior of which, called the 
coronoid processes, end in points which 
pass under the zygomatic arches. The 
temporal muscles are inserted into these 
processes. The posterior processes, calK 



33 

ed condyloid, or articulatory processes, 
are thicker and less elevated than the 
coronoid processes ; they terminate in 
oblong, smooth condyles, or heads, sup- 
ported by a cervix. To each condyle 
is attached a strong moveable cartilage, 
which is also attached to the cavity and 
eminence, which are for that purpose in 
the temporal bones $ they are further 
strengthened in their situation by a strong 
ligament attached to the temporal bones, 
and to the cervix of the condyles on each 
side. Thus, the under jaw is firmly 
united to the skull ; the loose intervening 
cartilage greatly facilitates its lateral 
motion, so necessary in mastication. 
The lower edge of this jaw is called its 
base, and the end of its base is its angles. 
In this bone are four holes ; two inter- 
nal, near the processes ; and two exter- 
nal, near the chin : by the internal holes 
enters a branch of the fifth pair of 
nerves, an artery from the carotids and 
vein fromthe jvglares, branches^: which 



34 

pass into the fangs of the teeth ; these 
vessels emerge again by the external 
holes, and spread upon the chin. That 
part of the bone in both jaws, which 
immediately surrounds the fangs of the 
teeth, is called the alveolar process. 

The growth of this process commen- 
ces with that of the teeth, and advances 
with them to maturity. 

The existence of the teeth and alveoli, 
so entirely depend on each other, that 
the loss of the former, is inevitably fol- 
lowed by the waste and absorption of the 
latter. Thus, the jaw bones of persons 
become toothless through age, have no 
sockets for teeth, but have a smooth and 
solid surface. 

The teeth are so formed as either to 
tear or grind, according to the nature of 
the aliment presented to them : which be- 
ing masticated, is received on the tongue, 
that, without the assistance of either bone 
or joint, adapts itself to every shape and 
posture, for the purpose of introducing 



35 

the food. This important organ also 
renders our thoughts vocal, enables us 
to communicate our sentiments, and by 
this faculty of speech, qualifies us for all 
the comforts and benefits of society. The 
tongue is terminated by the throat, con- 
taining the passage to the lungs, through 
which we breathe ; and the passage to 
the stomach, or gullet, by which we re- 
ceive food. The stomach, the reservoir 
of the food, may be considered as its di- 
latation. In its figure, it resembles the 
pouch of a bagpipe, and has two ori- 
fices ; the one which receives the crude 
aliment from the mouth, and the other 
which conveys the digested food, or 
chyle, to the upper part of the intestines. 
The food on being received into the sto- 
mach, undergoes an importanlchemicai 
change : the solvent fluid of the stomach, 
secreted from its coats, termed the gas- 
tric juice, acts upon it; and by the fur- 
ther assistance of heat, it is converted 
into chyle. This chyle is drawn off by 



36 

all the secretory orifices of the lacteal 
vessels, spread on the surface of the in- 
testines ; and the useless part separated, 
and receiving an admixture with the bile 
and other active fluids, is discharged un- 
der the form of feculent matter, after 
passing through the long and intricate 
convolutions of the cavity of the intes- 
tines. 

Thus, is the body supplied with food, 
and its waste repaired. For the choice 
of this food we are indebted to the senses, 
which are five in number, viz. the sight, 
the hearing, the smell, the taste, and the 
feeling. The eyes, which are the or- 
gans of vision, are placed in the upper 
part of the face, are of a globular struc- 
ture, and consist of simple fluids enclo- 
sed in thin tunicles. These tunicles 
are furnished with an apparatus of 
muscles, enabling them to perform all 
the varied motions of which they are 
susceptible. This power, combined with 
its elevated position, renders the sight 



37 

the most extensive of all the senses. It 
is through this sense only, that we are 
made capable of enjoying the sublime 
and most beautiful in nature and art. 
In sleep, its exercise is suspended, and 
the lids, those natural curtains, spon- 
taneously close for its protection, till the 
light of day again calls forth its active 
powers. 

Next to the sight is the hearing ; and 
the organ subservient to this, consists 
of an outward porch, the external ear, 
and an internal apparatus of the most 
admirable contrivance and workman- 
ship. The hammer, the anvil, the stir- 
rup, and the drum, are the names of its 
parts ; the winding labarynths, and the 
rounding galleries, with other pieces of 
its mechanism, are all formed to increase 
the power of hearing, in a manner cu- 
rious and intricate beyond description. 
It is through this sense the charms of 
music are enjoyed, and social inter- 
course maintained. While the eye is 



38 

Watchful only in our waking hours, the 
ear is expanded to receive impressions 
at all times, arid to warn us of danger 
before its approach. So important are 
the organs of sight and hearing in the 
estimation of nature, that she has shewn 
her anxiety of guarding against their ac- 
cidental loss, by bestowing duplicates 
of each. 

Smell, the next sense, is one through 
which also we receive much enjoyment. 
It has its seat, a fine set of nervous con- 
geries, spread every where on the inter- 
nal surface of the nose. Through this 
sense we inhale the flowery breath of 
Spring, the scent of autumnal fruits, the 
delights of the hay-field, the fragrance 
of the orchard, and the more delicious 
odours of the garden-rose. 

Taste, the next sense, has its resi- 
dence in the tongue and palate. Like 
a friendly monitor, it apprises, us of the 
safety or mischief of what we eat or 
drink, and, with the vigilance of a sen- 



39 

tinel refuses admission to any article of 
food till its qualities have been subject- 
ed to its scrutinizing test. 

The last sense, the touch, is seated in 
the skin, orthat covering which envelopes 
the whole body j it possesses, therefore, 
a wide range, and is not circumscribed 
to a particular place, as the others are. 
The skin is formed of the most delicate 
net work, whose texture is exceedingly 
minute, and whose threads are multi- 
plied even to a prodigy : they are so 
minute, that nothing passes them which 
is discernible by the eye, though they 
discharge every moment what con- 
stitutes insensible perspiration. The 
threads, indeed, are so multiplied, that 
the point of the smallest needle cannot 
pierce a single part without causing an 
uneasy sensation. The outermost co- 
vering of the skin is that soft whitish 
tegument, raised by a blister, termed 
the cuticle or scarf-skin. The true is 
that reddish and exquisitely tender part 



40 

which appears beneath the blister when 
broken. The former is void of sense, 
and intended to screen the true skin 
from the impressions of the air, and 
the effect of injuries. The colour of 
the cuticle is white. The apparent 
black or brown it acquires in the Ne- 
gro or Indian, is entirely owing to the 
mucous substance lying under it. 

The functions of the skin are exten- 
sive and important. It is the seat, as 
observed, of the sense of touch ; it is 
the channel of perspiration, and it ob- 
serves a sympathy with the internal 
parts; so that an intimate relation sub- 
sists between them, and a derangement 
of the internal organs is always mani- 
fested by the state of the skin : hence 
the countenance is a sure index of 
disease ; and nature has intended this 
change, in order to give us alarm in 
the first instance, and warn us of dan- 
ger : but the sense of touch is more ex- 
quisite in the points of the fingers than 



41 



any other part. Both the fingers and 
toes are furnished with the defence of 
nails, which are now considered as a 
continuation of the cuticle, as they are 
removed with it by boiling water or 
maceration. Like the cuticle, they are 
insensible, are renewable when separat- 
ed, and have no evident vessels : but 
they differ from the cuticle in structure, 
being formed of plates with longitudinal 
fibres, closely compacted ; they begin by 
a square root, a little before the last 
joint of the fingers and toes ; in their 
appearance, when separated, they are 
transparent as horn ; but in the living 
body are coloured by the vessels of the 
skin, to which they adhere, and from 
which they derive nourishment : — they 
are fixed at their root to a semilunar 
fold of the skin, and are there covered 
by a reflexion of the cuticle, which firm- 
ly adheres to them. Their growth pro- 
ceeds from the roots, not the points : by 
them the ends of the fingers and toes are 



strengthened and defended. In the fin- 
gers they increase the power of appre- 
hension, particularly in laying hold of 
minute bodies. 

The skin is also adorned in certain 
parts with a foliage of hairs: they arise 
by roots or bulbs from the cellular sub- 
stance under them. The bulbs are of 
various shapes in different parts of the 
body, and have blood-vessels dispersed 
upon them for their nourishment. Each 
of the bulbs has two membranous cap- 
sules, containing an oily fluid between 
them, which gives colour to the hair; 
for want of this in age, or under certain 
diseases, the hair changes its colour. 
Each hair consists of smaller hairs in- 
closed in a membrane, and is somewhat 
like the nature of the nails. Like them, 
it grows from the roots. Though all the 
uses of the hair are not yet known, it 
evidently serves for the warmth, pro- 
tection, and ornament of those parts, 
on or near which it is placed. 



43 

Such is a general view of the compli- 
cated and varied structure of man. When 
we contemplate the nicety and art with 
which every part is constructed, we 
should suppose it was intended to last 
for ages : experience, however, daily 
teaches us the reverse ; and that certain 
parts giving way, and falling into decay, 
occasion the destruction of the whole 
machine. 

The teeth, though the hardest parts of 
the human frame, and intended hy nature 
to survive every other, are, through ne- 
glect and mismanagement, the soonest 
which give way. The nature and dis- 
eases of these organs are what we are 
now to consider as the subject of the 
present volume. 



44 



OF THE 



FORMATION AND STRUCTURE 



TEETH. 



THE teeth consist of two parts : osse- 
ous matter, the sama as other bone j and 
enamel, their peculiar covering, which 
gives them their whiteness and polish of 
surface. Each tooth may be properly 
divided into three parts. 

First, — The crown, or that part which 
projects from the gum, and is the only 
division which possesses the covering of 
the enamel. 

Secondly, — The neck, or that part 
where the enamel immediately termi- 



45 

nates, and to which the gum is closely 
attached. 

Thirdly, — The fang, enclosed hy the 
socket, and inserted deeply into the 
jaw. 

At the point of the fang there is a 
small opening, placed for the passage of 
nerves and vessels, which are ramified or 
spread out on the lining of the opening 
within the tooth. In this manner the 
circulation and sensation of each tooth 
are supplied. The fang is, therefore, an 
important part, and of the same value 
as the root to vegetables ; preserving the 
tooth in its due position, and, at the 
same time, conveying to it the proper 
degree of nourishment. 

Man differs from other animals in be- 
ing provided with two sets of teeth : 
the first intended for the period of in- 
fancy, and consequently limited in their 
duration j the second intended for the 
remainder of life, and, therefore, of a 
stronger and more compact texture. The 

E 2 " 



46 

teeth, in their first formation, unlike 
other bone, instead of having for their 
base cartilage or membranous substance, 
are formed from a soft pulpy matter 
resembling their shapes, and may be 
distinctly seen at the time of birth. As 
soon as they have attained their shape, 
grooves are formed, into which the sur- 
rounding vessels deposit the pulpy mat- 
ter, constituting the rudiments of the fu- 
ture teeth. 

At the age of five or six months, this 
pulpy matter has a regular arrangement, 
and is enclosed in membranous sacs or 
bags, ten in number, in each jaw, cor- 
responding to the number of the tempo- 
rary teeth. This first appearance is 
succeeded by ossific fibres shooting 
across, and dividing the sacs into their 
respective compartments, which are the 
commencements of the future sockets. 
About the seventh month, the ossifica- 
tion commences, both on the cutting 
edges of the first teeth, and on the pro- 



47 

minent points of those situated further 
back in the jaw. 

At birth, the bodies of all the first set 
appear distinctly formed in each jaw ; 
but, at this time, they are ossified only 
on the external parts, and the unossified 
pulp within is merely covered with a 
shallow bone. As the teeth proceed in 
their ossification and shape, the invest- 
ing membranes adhere more closely to 
their necks ; and by this attachment 
they secrete and deposit over the crowns 
of the teeth a fluid, from which a very 
white substance is deposited upon the 
bone. This is the enamel, which is at 
first of a consistence not harder than 
chalk; but in age it acquires such a 
hardness, that a file in cutting it, is soon 
worn smooth. 

After birth, the growth of the teeth is 
rapid, and cannot, therefore, be confined 
long within the alveolar cavity or socket; 
they lengthen chiefly from the bodies ; 
those of the under jaw downwards, and 



those of the upper jaw upwards. The 
parts that first lengthen are shaped into 
fangs ; and, as this takes place, the sockets 
grow round, and more closely invest them. 
On the progressive ossification of the 
teeth, their original membranous cover- 
ings undergo the process of absorption, 
and are carried out of the system, having 
completed their original and destined 
purpose. In the progress of this growth 
of the teeth, a corresponding growth 
takes place in the sockets or alveolar 
plates; at first, they grow much faster 
than the teeth themselves, which are 
consequently, but loosely, contained in 
them ; and this rapidity of growth is 
necessary, both to render the soft gum 
capable of sustaining pressure, as well 
as to protect the embryo teeth from 
injury. Hence, in the mode of their 
growth, it may be observed, that the 
outer edges of the sockets or plates grow 
higher, and turn a little over in order to 
approach each other : the gum then 



49 

hardens over ; — and thus the teeth are 
fully protected, and the gums rendered 
sufficiently firm to undergo every neces- 
sary degree of pressure. 

The protrusion of the first set of teeth 
begins as early as at the end of four or 
five months after birth, though in this 
there is a considerable variation ; nor 
does this variation depend on the strength 
or delicacy of the child ; for we often 
find that delicate children commence 
dentition very early,' while, on the other 
hand, strong children are very slow in 
acquiring their teeth : nay, there are 
some instances where children have 
shewn no appearance of teething until 
the fourteenth or fifteeth month. The 
general rule, however, is, that their 
protrusion begins from the sixth to the 
eighth month after birth : the mode in 
which they affect a passage through the 
gums, is by the process of ulceration. 
The teeth pressing on the membrane 
which encloses them, occasions its ab- 



50 

sorption ; and the pressure being next 
continued on the gum, causes that also 
to give way. 

The order in which the teeth succes- 
sively make their appearance, may be 
thus described : first, the two front in- 
cisores, or cutting teeth, of the under 
jaw, — one generally appearing a few 
days before the other; for, though form- 
ed in pairs, they seldom protrude at the 
same time. In about a month after, those 
are succeeded by the front incisores of 
the upper jaw. Next follow the lateral 
incisores of the under jaw, and soon after 
those of the upper jaw. A deviation 
from the order, hitherto observed, then 
takes place; and, instead of the cuspidati, 
or canine teeth, which are next in suc- 
cession, the anterior molares, or double 
teeth, appear in the under jaw ; and 
these are soon after succeeded by those 
of the upper jaw. Then follow the 
large inolares which completes the first 
or temporary set. The whole process 



51 

generally occupies a period of about two 
years and a half. 

Though this is the regular course 
observed by nature, there are, at times, 
exceptions to this order of protrusion ; 
for, instead of the front incisores, the 
lateral incisores are discovered first 
through the gums, and the small molares 
before the lateral incisores. It may be 
remarked, also, that children have been 
born with the two front incisores of the 
under jaw through the gum, but such 
premature birth is always imperfect; 
these teeth possess no fangs, and are 
attached chiefly to the gum, which oc- 
casions pain and irritation to the child; 
on which account it is generally found 
necessary to extract them. 

The period of dentition is often highly 
critical to the constitution of the child, 
as it not only occasions disease, but 
generally aggravates any other disorder 
which may occur at the time ; yet, it is 
well known, that this period sometimes 



52 

elapses unaccompanied by any particu- 
lar symptoms of pain or uneasiness. 

The appearance of the teeth is clearly 
an effort of nature, in which she effects 
the absorption of the investing mem- 
brane, the alveolar process, and the 
gums, to make way for their passage ; 
but the teeth sometimes advancing too 
rapidly, occasion a strong tension and 
pressure on the vessels of the gums, 
which produces pain and irritation in 
the surrounding parts. Hence, the gums 
appear swelled and inflamed, a constant 
discharge of saliva takes place from the 
mouth, and often a general sympathetic 
fever prevails over the whole system. 

At this stage of the fever, which fre- 
quently proves fatal, the treatment of 
the child, both as respects the parts 
affected, and the system in general, de- 
mands particular attention. 

It is commonly recommended to allow 
the child some hard substance to press 
against the gums, which, though it may 



53 

afford a temporary relief, generally in-^ 
creases the inflammation and uneasiness. 
A more effectual means of relief would 
be afforded by producing a gentle fric- 
tion on the gum, with the finger and a 
little fine salt; which, by exciting a co- 
pious flow of saliva, and thus reducing 
the action of the vessels, would tend to 
alleviate the inflammatory symptoms. 
But an early recourse to the lancet is 
the safest expedient, and the only one 
that is to be depended on. An incision 
made with this instrument over the tooth 
that is the cause of irritation, either in 
a linear or cruciate form, as the tooth is 
single or double, would not only ad- 
minister instantaneous ease to the little 
sufferer, but would prevent or remove 
^very distressing and dangerous symp- 
tom with which dentition is often at- 
tended. But little skill is required in 
performing so simple and safe an opera- 
tion, particularly if the lancet, the au- 
thor has invented for the purpose, be 



5$ 

employed. The operator must see that 
his instrument reaches the seat of the 
mischief ; and not be satisfied with 
barely dividing the gum, but, also, the 
membrane below the gum, that is in im- 
mediate contact with the tooth. The 
division of this membrane, from its 
tougher texture, will acquire some little 
pressure of the lancet, (and, with the 
instrument commonly used, a conside- 
rable one,) from which it need not be 
apprehended the tooth can sustain the 
slightest injury. 

And here I cannot but seize the pre- 
sent opportunity of combating the preju- 
dice that so generally prevails in the 
minds of parents against the use of the 
lancet. Let them be assured, it is ab- 
solutely impossible the slightest harm 
can arise from its use, even when the 
operation is discovered to have been un- 
necessarily performed. When parents 
are even convinced of its necessity, their 
fears frequently induce them to postpone 



55 

the operation till fatal symptoms of 
convulsion appear, which frequently 
prove fatal, and in one moment awfully 
reproach their indecision, by hurrying 
their infant offspring to another world. 
But let not the most threatening symp- 
toms of danger deprive the afflicted 
mother of her presence of mind, but let 
her apply immediately to the lancet; 
for the author has known many a child 
snatched, as it were, from the arms of 
death, when the delay of its application, 
even for a few seconds, he has the 
strongest reason to suppose, would have 
terminated their existence. 

The general irritation of the system 
which attends teething, is marked by 
the following leading symptoms : 

Flushings of the cheek and fever, 
which is generally sudden in its attack. 
The eyes of the child first become heavy; 
he is hot and restless, putting his hand 
often into his mouth. The tongue be- 
comes white, the skin dry, and the ap- 



56 

petite and rest are disturbed. These 
symptoms become often so aggravated, 
that delirium succeeds, convulsions su- 
pervene, and a fatal termination takes 
place. 

Where fever is not so predominant, 
diarrhoea is a common symptom, which, 
if gentle, is attended with beneficial 
effects, and assists in taking off the irri- 
tation ; but when, on the contrary, it is 
violent, of a green colour, and attended 
with much griping, the child becomes 
exhausted, its rest is constantly disturb- 
ed, startings and convulsions supervene, 
and the termination is often fatal. 

Another symptom of general irrita- 
tion at this period is, the appearance of 
different eruptions on the skin. These 
are attended with considerable variety, 
and are often thought to arise from a 
different cause than that of teething j but 
the period of their occurrence marks 
their origin, and every remedy is found 
ineffectual, till the irritation of teeth- 



57 

ing is past. — Such are the symptoms 
which the protrusion of the first set oc- 
casions. 

The permanent set, on the contrary, 
occasions no uneasiness or pain. These, 
like the others, are formed before birth ; 
but, in the formation and perfection of 
this set, we may observe, a very impor- 
tant part of life is occupied ; twenty 
years being necessary for their complete 
evolution. They consist, generally, of 
thirty-two in number; being twelve more 
than the primary set, and are divided 
into four classes, namely, eight incisores, 
four cuspidati, eight bicuspides, eight mo- 
lares, and four dentes sapientice: if more, 
they are termed supernumerary teeth. 

The formation of both sets of teeth 
correspond to the elongation or growth 
of the jaws, and the changes are exhibit- 
ed in the following order : the tempora- 
ry incisores and cuspidati of the child, 
are succeeded by larger ones of a similar 
form i while those which succeed the 
f2 



98 

temporary molares, are much smaller, 
and, being divided or irregular on their 
grinding surfaces, are called bicuspides. 
The adult molares, which succeed each 
other as the jaws advance in growth, all 
differ in the number and shape of their 
fangs. 

The size of the teeth is originally de- 
termined by the deposition of ossilic 
matter assigned them, so that, on their 
appearance beyond the gum, their growth 
may be considered as completed, for 
they neither increase in size nor alter in 
shape. 

The first set, or temporary teeth, hav- 
ing answered their purpose, the perma- 
nent teeth, formed in sockets behind 
them, and which have been gradually 
proceeding in growth, by pressing for- 
ward, possess the situation of the others : 
and in this, they are often impeded by 
the roots of the temporary set, which 
have never been absorbed. 

This effort, which facilitates the re- 



59 

moval of the temporary set, is one of 
the most curious operations of nature. 
The absorption takes place in the in- 
cisores about the fifth or sixth year, and 
proceeds in rotation, as the teeth origi- 
nally protrude through the gums. The 
Absorption is retarded by uncleanliness, 
and disease of the teeth and gums, which 
occasion irregularity in the permanent 
set 



60 



SHEDDING OF THE TEETH, 



THE changes which the teeth under-* 
go form a very interesting part of Na- 
tural History ; and is absolutely requisite 
to be known by every parent, to enable 
them to render such assistance, during 
the progress of the second dentition, as 
may prevent the permanent teeth from 
acquiring that irregularity which occa- 
sions so much deformity of the face, and 
often destroys correct enunciation. 

The period when the temporary teeth 
begin to shed, is usually between the 
fifth and seventh year. On the removal 
of the front incisores of the under jaw, 
the permanent ones immediately succeed, 
and next the four first permanent molares 
appear ; and then the permanent inci- 
sores of the upper jaw, which are sue- 



61 

ceeded by the lateral incisores of the un- 
der jaw, and soon after by those of the 
upper. The bicuspides are the next in 
order : first, the anterior ones of both 
jaws, and soon after the posterior ones ; 
the cuspidati of the under jaw next ap- 
pear; then the corresponding ones of 
the upper ; and, near the same time, the 
middle molares make their appearance 
in both jaws, which is, generally, be- 
tween the eleventh and thirteenth year; 
and, lastly, the posterior molares, termed 
dentes sapientise, or wisdom teeth. The 
time of their protrusion is more uncer- 
tain than the others ; sometimes they 
appear as early as the eighteenth year, 
and at other times not before the fortieth 
year. Such is the time occupied by na- 
ture in the perfection of the permanent 
set of teeth ; and such is the order in 
which they generally appear. Though 
the number of the second set is found to 
be thirty-two in all, yet a natural defi- 
ciency of them often occurs ; but these 



62 

aberrations of nature are very rare: in- 
stances are even stated of persons not 
having any teeth; in such cases the 
gums are found sufficiently callous, and 
competent to every purpose of mastica- 
tion. 

Having thus described the two sets of 
teeth, it will be further necessary to con- 
sider, that part of their structure which 
is peculiar to these organs, and which 
qualifies them for the proper discharge 
of their office. This part is the cortex 
striatus, or enamel, which consists of a 
crystallization, formed by a soft earthy 
matter, deposited by the investing mem- 
branes on the bony layers of the crowns 
of the teeth. Its appearance, at first, 
is in fibres or streaks, running from the 
circumference to the centre of the teeth. 
As it hardens, these fibres arrange 
themselves into arches over the bodies of 
the teeth. Hence, by this mode of ar- 
rangement, arises its durability and 
strength, to resist, without injury, the 



63 

frequent actions to which it is exposed. 
The enamel, though thus so hard and 
strong, is not above half a line in thick- 
ness; but this thickness is increased on 
the cutting edges and grinding surface 
of the teeth; its hardness may be consi- 
dered as tempered steel, and when struck 
againstthe latter it will emit sparks. The 
enamel, in many cases, appears imper- 
fect ; and where indented spots are seen on 
its surface, they may generally be attri- 
buted to uncleanliness of the mouth dur- 
ing the growth of the teeth. The ena- 
mel consists of three principles, viz. 
phosphate of lime, carbonate of lime, and 
gelatine, in different proportions. It is, 
at first, of a consistence not harder than 
chalk; though, when the teeth appear 
through the gums, it has acquired the 
firmer texture of bone ; yet it is often so 
acted upon by particles of food and dis- 
ease of the gums, as to assume a honey- 
comb appearance. 
Having considered the formation and 



64 

progress of the teeth, to the complete 
evolution of the permanent set, it will 
now be proper to examine, not only the 
diseases to which, as organized bodies, 
they are exposed, in common with other 
bone, but also the disorders to which 
they become liable, from the peculiarity 
of their situation. 

As diseases of the teeth not only injure 
the gums and taint the breath, but also 
affect the alveolar processes, their treat- 
ment should be undertaken only by an 
operator that is thoroughly acquainted 
with the principles of surgery. 

Whatever affects the teeth, is readily 
communicated to their appendages ; and 
hence, the alveolar processes and sock- 
ets, from their intimate connection, in- 
variably become more or less diseased. 
The teeth, from the compactness of their 
structure, do not, like other bone, pos- 
sess sufficient power to effect exfoliation, 
or the natural removal of disease ; neither 
is it in their power to bring on the pro- 



65 

cess of suppuration, which nature em- 
ploys as a salutary change to carry off 
the morbid effect that takes place; and 
when inflammation commences, if not 
speedily removed, occasions gangrene, 
or a death of the affected parts. 



66 



THE ADULT TEETH. 



THE teeth may be viewed, in some 
degree, as extraneous bodies, not liable 
to those diseases which affect the rest of 
the system. This has not been duly con- 
sidered by preceding writers, who have 
generally supposed these substances to 
be affected by all those circumstances 
which influence the rest of the body, and 
which are here, on the contrary, from 
the nature of their composition, of no 
effect whatever. The diseases of the 
teeth are simple; and they are only 
changed by that chemical agency which 
is immediately applied to them, and 
which never fails, when exposed for 
any length of time to its influence, to 
produce an erosion of their enamel. 
The adult, on the discovery of a carious 



67 

tooth, may date the mischief even as far 
back as the period of childhood, when 
the means of prevention should have 
been administered. 

Numerous are the causes of diseased 
teeth and gums, stated by writers ; but 
these causes may be considered, for the 
most part, as ideal. It has been assert- 
ed, that climate has a considerable in- 
fluence in this respect; that the inhabi- 
tants of warm countries have sound 
teeth, while those in the colder regions 
have diseased teeth. But this is contra- 
dicted by plain fact ; for we find persons 
both with sound and diseased teeth in 
every climate, which shews it is not to 
that cause the disease is to be attributed. 
The same may be said of the luxuries 
of the table, in respect to sauces, acids, 
sweetmeats, &c. For the teeth, the hard- 
est substance of the animal machine, 
can never be acted upon by the transient 
passage of certain articles of food and 
beverage into the stomach. The same 



68 

observation will apply to heat and cold, 
and to the temperature of substances 
taken into the mouth. This temporary 
influence can never, of itself, produce 
disease in the teeth. 

To what then are the disorders of the 
teeth to be attributed ? This is an inter- 
esting question ; and one whose solution 
escaped even the penetration of those ce- 
lebrated physiologists, Hunter and Fox. 
I esteem it, indeed, a most fortunate 
circumstance, that my attention was so 
early and closely engaged by an enquiry 
of such general importance : and I can 
now assure my readers, that the result 
of my labours, founded on the successful 
prosecution of a series of the most nu- 
merous and satisfactory experiments, 
few have had even an opportunity of 
making is, that the relics of what we eat 
or drink, (without regard to its qiialitij) 
being allowed to accumulate, stagnate, and 
putrefy, either in the interstices of the teeth, 
as is most commonly the case, or else in 



09 

those indentures on their surface, favour 
able for the lodgement of food, is univer- 
sally the cause of their decay, and general- 
ly of most otlier disorders, to which they 
are exposed. 

The great and leading cause, there- 
fore, of the diseases of the teeth and 
gums, is to be sought for in the exercise 
of their functions. Being the agents of 
introducing the supplies to the system, 
they must act on these supplies mechani- 
cally, and fit them for passing into the 
stomach ; and, in doing so, part of that 
matter, of which the supplies consist, 
must adhere, and receive, if allowed to 
remain, that change which enables it to 
act upon, and erode their enamel and 
bone ; and to contribute to that peculiar 
secretion on the teeth, known by the 
name of tartar, which is another cause 
of inflammation and disease of the gums. 

This is the true source o/caries, or decay 

of the teeth, which the two late eminent 

writers before-mentioned, find so difficult 
g 2 



70 

to account for ; and of which discovery 
I cannot help feeling a pride and pleasure 
in avowing myself the author; for I can, 
with confidence, assert, that if the teeth 
and gums are regularly cleaned with the 
dentifric apparatus, recommended by the 
author, no caries can possibly take place. 
This then is a simple and clear view of 
the subject, and the grand desideratum 
for retaining these important organs in 
a sound and healthy state, to the latest 
period of existence. The mode of clean- 
ing the teeth, as usually performed, is to 
rub them with a brush and a prepara- 
tion of tooth powder, or tinctures, (to 
which some great quality is ascribed f) 
but, in wiiatever way it is employed, 
the source of the evil still remains; for 
the interstices and irregularities of the 
teeth afford a lodgement for whatever is 
taken into the mouth ; and no contrivance 
hitherto discovered can, from these 
parts, remove the accumulation. 

After much experience and reflection 



71 

on the subject, I found it necessary to 
construct a dentifric apparatus, which 
is found to answer every purpose, and 
to obviate the defects in common prac- 
tice. This apparatus consists of three 
parts, contained in a small case, with a 
dental mirror, fit for the toilet or the 
pocket. 

The first part to be used is the brush.* 
It is made hollow 7 in the middle, to em- 
brace every part of the teeth, except the 
interstices ; and thus, at one operation, 
the top, (a part hitherto entirely ne- 
glected) the outer and inner surfaces 
are completely freed from all extraneous 

* As public utility, more than emolument, is the 
object of Mr. Parmly, he has resisted the advice 
of his friends, in declining to take out a patent for 
his brush; he cannot, however, but submit it to the 
feelings of a well known Dentist, at the west-end of 
this Metropolis, how far sentiments of candour or 
justice can warrant him in affixing his name to this' 
article, and assuming to himself the credit of the 
invention* 



. 72 

matter. The second part is the dentifiic 
polisher, for removing roughness, stains, 
&c. from the enamel, and restoring to 
the teeth their natural smoothness and 
colour. The third part is the waxed silken 
thread, which, though simple, is the 
most important. It is to be passed 
through the interstices of the teeth, be- 
tween their necks and the arches of the 
gums, to dislodge that irritating matter 
which no brush can remove, and which 
is the real source of disease. With this 
apparatus, thus regularly and daily used, 
the teeth and gums will be preserved 
free from disease ; the use of powders, 
tinctures, &c. will be superseded ; and 
the breath will not be loaded with that 
putrid effluvium, which, besides its pub- 
lic annoyance, is the cause of numerous 
disorders. Indeed, were persons suf- 
ficiently attentive to cleanliness of the 
mouth, diseases of the teeth and gums 
might be prevented, without the neces- 
sity of any painful operation, which 



73 

would contribute no less to the improve- 
ment of the features of the countenance, 
than to the promotion of general health 
and comfort. Having thus pointed out 
the simple and successful method of 
preserving the teeth and gums, and 
rendering the breath agreeable, we will 
now consider their treatment when in 
a diseased state, and rectify the practice 
of former dentists. 



74 



TREATMENT 



DISEASED TEETH AND GUMS. 



THE means of prevention, pointed out 
in the preceding part of the work, ap- 
pear at first sight, interesting only to 
those whose teeth are not yet attacked 
by disease. Where, however, it has 
actually commenced, and undergone the 
specific treatment adapted to its cure, 
the means of prevention, already insist- 
ed on, will be equally efficacious against 
any future attack. 

The treatment of the diseases of the 
teeth constitutes an important branch of 
surgery ; and it is proper and almost 
indispensable, that every person, and 
particularly parents, should have some 
acquaintance with the operations be- 



75 

longing to this branch, that they may 
form some idea themselves of what is 
proper to be done, and what may be 
reasonably expected from the person 
who denominates himself a professor of 
the dental art ; individuals will thus be 
guarded against the exaggerated pro- 
mises of empyrics, and form just expec- 
tations for themselves of what can be 
done for their relief and improvement. 
For, whatever experience and manual 
dexterity the dentist may profess, he can 
never perform miracles, or effect any 
thing more than is rendered practicable 
by the laws of nature, and a knowledge 
of the structure of the teeth and their 
appendages. 



76 



CARIES. 



CARIES, or the decay of part of the 
teeth, arising from uncleanliness of the 
mouth, is the most frequent disease to 
which they are liable. It commences, 
generally, in the interstices and irregu- 
larities of the teeth, in the form of a 
small dark spot on the enamel, which, 
eating it away, passes inwards, and oc- 
casions a still more rapid decay of the 
bone, till the tooth is entirely destroyed. 
It has been a grand mistake with authors 
on this subject, that caries commences 
internally, and acts on the bony sub- 
stance of a tooth. The enamel, how- 
ever, may be considered at all times, the 
first seat of attack; though, on the bone, 
from its softer texture, it makes a 
greater and quicker havock than on the 



77 

outer crystallized covering, which, to 
the eye, appears oftentimes scarcely 
perforated. 

The wasting of the hone thus deprives 
the enamel of its support, so that the 
least pressure, on masticating hard sub- 
stances, causes it to break away, which 
exposes it to the action of every external 
substance ; and then a cavity is disco- 
vered in a tooth which had been sup- 
posed, previously to this, perfectly sound. 
Mr. Fox, and other writers, observed, 
that one part of a tooth is not more lia- 
ble to disease than another j but the very 
nature of the cause which produces ca- 
ries, viz. the relics of the food lodging 
in the interstices, proves, that those are 
the parts in which diseases generally 
commence. The molares are usually 
more decayed than any other of the teeth. 
This arises not only from their being 
more neglected than those placed in the 
prominent part of the mouth, but, from 
their indented surface, affording easier 



78 

lodgements for food than the other teethj 
and for the removal of which, my new 
invented brush is so well adapted. The 
caries, or decay often begins on those 
sides of the teeth which are placed in 
apposition to each other ; and, from the 
nature of the cause, which acts by a 
putrefactive process, there is no doubt, 
that, among the sound teeth, any one 
which is contiguous to a tooth that is 
decayed, is the most liable to diseased 
action. The incisores of the upper jaw, 
are, also, very frequently affected in this 
way, while those of the under jaw are 
very seldom known to decay. Their 
preservation arises from the under jaw 
being more exposed to the action of the 
saliva, the solvent powers of which pre- 
vent the relics of the food from injuring 
the teeth. The first appearance of ca- 
ries, in every instance, is, by a disco- 
louration, as before noticed, of the af- 
fected part ; and, when a decayed tooth 
is examined, the diseased part appears 
to be disposed in strata, the external 



79 

layers of which are most decayed, as- 
suming a blacker appearance, and are 
rendered so soft as easily to be cut away. 
The next are of a harder nature, less 
discoloured, and gradually exhibiting a 
firmer texture, till we reach the part that 
is perfectly sound. When the opaque- 
ness of the enamel indicates the attack 
of caries, if the tooth is sawn through, 
a brown mark will be discovered, ex- 
tending towards the natural cavity. — It 
is in this direction the disease proceeds, 
and, on the cavity being exposed, the 
investing membrane, and its ramifying 
nerves and blood-vessels, discover inflam- 
mation, which is the cause of tooth ache. 
During the progress of caries, the inter- 
nal part of the crown, from its softer 
texture, suffers most, and is, therefore, 
soonest removed, which causes the inside 
to appear excavated. When the whole 
crown is destroyed, the progress of dis- 
ease seems somewhat suspended ; and the 
fangs will often remain, for many years, 



80 

with little alteration, from the cause of 
the disease not having the same field to 
act upon as it had on the crown, which 
is always an exposed part; and the 
fangs will even continue firmly attached 
to the socket, without the least incon- 
venience. 

Hence, persons seldom experience the 
pain of tooth ache, from what are termed 
stumps ; for, hy the disease destroying 
the body of the teeth, the investing mem- 
brane, and its blood-vessels, are remov- 
ed, and the circulation to the fang is thus 
cut off. 

Pain, therefore, from stumps, arises 
from their acting as extraneous bodies 
on the sockets ; and thus exciting in- 
flammation, which often terminates in 
suppuration. 

It is surprising, that the cause of caries 
should have been so much misunderstood. 
Mr. Hunter goes so far as to say, that 
it does not arise from external injury, 
or from menstrua, which have the power 



81 

of dissolving part of a tooth, and that 
we may reasonably suppose that it is a 
disease originally arising in the tooth 
itself. This idea is acceded to by Mr. 
Fox, who expresses the same doubt and 
obscurity respecting it. But if we at- 
tend to the commencement and progress 
of the disease, it appears evident, that 
the cause is of an extraneous nature, as 
before-mentioned ; that it first affects 
the enamel in one point, and that this 
point is in a situation most liable to be 
acted upon, by the relics of the food and 
beverage which, from heat and stagna- 
tion, undergoing a putrefactive fermen- 
tation, acquire a sufficient solvent power 
to produce disease. The proof that this 
is the true cause of caries, is evident 
from the fact, that those who daily and 
regularly clean their teeth, even in the 
common method, are not so subject to 
this disease, because less lodgement can 
then take place in the interstices, or else- 
where to act upon them. 

H 2 



82 

Mr. Fox, therefore, following his pre- 
decessors, has bewildered himself on this 
subject, and lost sight of the true cause. 

He ascribes it, in the first place, to a 
state of ill health, during the formation 
of the teeth, which renders them unable 
to resist the causes of disease. But this 
cause would extend equally to all the 
teeth, if it arose from a general weak- 
ness of the system. He next attempts to 
account for it, from a state of constitu- 
tion connected with dyspeptic symp- 
toms, or stomachic complaints. 

But this cause, like the other, could 
only act by depriving the body of its 
due portion of nourishment, and the 
teeth of course as a part : to this must 
be ascribed, the pearly white appearance, 
he remarks on them : but it never could 
induce a specific action on particular 
teeth, the leading point contended for. 
Certain kinds of diet, he next resorts to, 
as the source of caries ; but whatever 
we eat or drink, can only act on the 



83 

teeth while it remains in the mouth : yet 
so far we agree with him, that the relics 
of any diet, allowed to stagnate in the 
interstices, as we have already pointed 
out, will be sufficient to produce the dis- 
ease, without the aliment being of any 
particular kind. The same objections 
apply to the influence of temperature of 
the atmosphere ; for in all countries 
teeth are found sound and healthy. This 
is a proof, that the cause is entirely of 
a local nature, and confined to that part 
where the disease first appears. 

Caries, it is clear, can never arise 
from irregularity of the teeth, nor yet 
from their being placed too close to each 
other, or improperly situated in any 
part of the mouth; excepting, so far, as 
such circumstances may afford a more 
convenient lodgement for food and other 
matter, to act upon them chemically. On 
the subject of caries, from the above 
facts, we are led to conclude, that no one 
part of the teeth is more liable to 



84 

disease than another; and that caries is 
not peculiar to them at any certain pe- 
riod of life : but, when the cause is ap- 
plied, the decay is more rapid in child- 
hood than in the adult; which has given 
rise to the common expression of « bad 
teeth, so young, I am surprised.' 5 This 
surprise instantly ceases, when it is con- 
sidered, that the teeth of young children 
are very little harder than wood. In 
dismissing this subject on caries, it may 
not be amiss to state, that the calamities 
of war have afforded the author an op- 
portunity, with which few, perhaps, of 
his profession, have been favoured, of in- 
vestigating the true cause of caries; and 
of satisfying himself, in regard to the 
accuracy of his own theory. He lias 
now, in his possession, thousands of 
teeth, extracted from bodies, of all ages, 
that have fallen in battle, inflicted with 
caries from its first commencement to 
the last stage of the disease; and he 
will undertake to satisfy the most seep- 



83 

tieal on this point, that caries univer- 
sally commences externally. What has, 
in all probability, given rise to a con- 
trary opinion is, that the aperture in 
the enamel, through which this disease 
finds its admission, is, in many cases, so 
exceedingly minute, as to escape the de- 
tection of all, but those who are aware 
of its true cause. 



86 



TARTAR. 



EXCEPTING the disease of caries, 
nothing is so destructive of the healthy 
condition of the mouth, or of the dura- 
bility of the teeth, as the accumulation 
of tartar. This is an earthy substance, 
held in solution by the saliva, and is 
deposited on the teeth as the saliva 
undergoes decomposition. Almost every 
person is subject to the formation of it, 
in a greater or less degree ; in some, 
the deposit is so habitual and copious, 
that, without unremitting attention, there 
is no guarding against its accumulation ; 
whereas in others, it is so small in quan- 
tity, that the least degree of care is suf- 
ficient to keep the teeth perfectly free 
from it. Similar concretions are known 
to be deposited in other parts of the 



87 

body, of a nature corresponding with the 
fluids that pervade those parts of the 
system. 

In some, the tartar is deposited in 
greater quantities, during disorders of 
the alimentary canal. It is also in- 
creased by an inactive and obstructed 
perspiration. Hence, its accumulation, 
during sleep, is greater than at any other 
time. It soon acquires a hard con- 
sistence, insinuates itself under the 
gums, and detaches them from the necks 
of the teeth. Thus the gums become 
subject to inflammation and pain, gradu- 
ally recede from the teeth, and produce 
an absorption of the alveolar process. 
So, in proportion to the increase of tar- 
tar, and its adhesion to the teeth, their 
natural support is destroyed, they be- 
come loosened in their sockets, and at 
last fall out. This happens to one tooth 
after another, until the whole are lost. 
When the teeth come out in this man- 
ner, they appear, on inspection, perfectly 



88 

sxwnd, and betray no mark of caries or 
other disease ; for the tartar acts as an 
artificial covering to the natural enamel ; 
and while it loosens them in their sockets 
and detaches them from their situation, 
it protects them from the action of other 
external agents, whenever it covers them. 
When it is allowed to accumulate, it 
thickens, and becomes hard on the parts 
which do not undergo friction, parti- 
cularly between the teeth, and at the 
base of their crowns next the gums, as 
well as about those teeth situated near the 
openings of the salivary ducts. Hence 
the incisores of the under jaw, and the 
molares of the upper, are most covered 
by it 

Where any of the teeth are wanting, 
so that friction does not take place in 
the act of mastication, the tooth corres- 
ponding to the one lost, very rapidly be- 
comes encrusted with tartar. 

The colour of tartar is various, as 
well as its consistence j when soft, it has 



89 

a yellowish appearance, but, as it thick- 
ens it becomes of a dark brown or of a 
blackish colour. Its accumulation gives 
always to the teeth, a disgusting and 
uncleanly appearance, and though in 
itself inodorous, yet from its effect in 
producing diseased gums, the breath re- 
ceives a disagreeable taint. 

As it forms, it deposits itself in layers, 
acquiring often such an extraordinary 
magnitude, as to equal the size of the 
teeth themselves. In some cases, the 
tartar has been known to acquire a pe- 
culiar corroding nature : in this case, its 
colour differs from common tartar, being 
of a dark green, and it is more of a fluid 
than of an earthy nature, having little 
tendency to incrustate. It is perhaps 
this species of tartar, which is mention- 
ed by Dr. Armstrong, of St. Vincent, 
when he states the fatal diseases which 
often follow the bite of the negro there, 
and which he attributes to the noxious 
i 



90 

qualities contained in the tartar of their 
teeth. 

The analysis of tartar has been made 
by several chemists, and it seems chief- 
ly made up of phosphate of lime—its 
earthy part ; the remainder, consisting 
ofjibrina, the foundation of the animal 
solid, and a proportion of oil or fat. Of 
these materials, the phosphate of lime is 
by far the most abundant. 



91 



TOOTH ACHE. 



THE ultimate effect of caries, is, by 
denuding the internal structure of the 
teeth, to produce that unpleasant and 
painful sensation, termed tooth ache. 
The pain attending it, is, in various de- 
grees, according to the influence of ex- 
ternal agents, on the denuded part. 
Often it is so acute, as to produce deli- 
rium and convulsions. At other times 
it is moderate, and rather a gnawing 
than an acute pain. The caries has ge- 
nerally made some progress before tooth 
ache commences. The pain is com- 
monly sudden in its attack, darting 
from the tooth through the head, and 
affecting the whole jaw. Where fits of 
tooth ache frequently occur, they be- 
come so violent and constant, that the 



92 

rest is disturbed, the appetite fails, and 
the person is unable to pursue his usual 
vocations. The original seat of tooth 
ache is always confined to the cavity 
of the teeth, and not to the investing 
membrane, as erroneously supposed. In 
the progress of the disease, the mem- 
brane, and all the contiguous parts, be- 
come inflamed, occasioning considerable 
swelling, which having attained a cer- 
tain height, the pain often, in some de- 
gree, subsides, though in other cases it 
becomes more acute, and ends in suppu- 
ration of the surrounding parts. In se- 
vere cases of tooth ache, the swelling 
and inflammation of the surrounding 
parts is so great, that the mouth cannot 
be opened, and the eye often becomes 
nearly closed. The swelling has even 
been known to extend down the neck, 
and to be productive of general irrita- 
tion. When this is the case before its 
termination, suppuration ensues, and the 
alveolar processes in consequence of 



93 

their inflamed state, are removed by the 
process of absorption. 

Where matter repeatedly forms about 
the fangs of the teeth, the sockets be- 
come so much absorbed as to loosen the 
teeth ; and even the jaw bone occasion- 
ally suffers from this inflammation, and 
its partial mortification at times is known 
to ensue. 

When this misfortune happens, it can 
only be remedied by the process of ex- 
foliation, which is slow in its progress, 
and occasions a greater or less deformity 
for the remainder of life. The pain of 
the teeth is often peculiar to the situ- 
ation of the tooth affected. Thus, when 
it attacks the dentes sapientice, or wisdom 
teeth, of the lower jaw, it is not felt so 
much in the teeth themselves as in the 
ear. When it affects those of the upper- 
jaw, it seems to shoot more directly up 
to the temple. In all cases, a remarkable 
sympathy seems to prevail between the 
affections of the teeth and the earj for 
I 2 



n 

pains in the teeth cause a similar suffering 
in the ear, and, in like manner, harsh and 
discordant sounds produce an unpleasant 
sensation, known by the term of the teeth 
being set on edge. But the most alarm- 
ing disease, connected with the state of 
the teeth, is that affection, known by the 
name of Tic Douloureux. This disease 
consists in the irritation of certain 
nerves, the commencement of this irri- 
tation is connected with the teeth, and is 
of a most alarming nature. The pain is 
most excruciating, and recurs in fits on 
the slightest agitation, produced by mas- 
tication, speaking, walking, riding, &c. 
The nature, however, of this disease is 
but little understood, and is fortunately 
but of rare occurrence. 

Indeed, such is the sympathy of the 
teeth with each other, and the diffusion 
of pain from one to another, that the pa- 
tient has often a difficulty to point out 
the original tooth from which the pain 
proceeds. Hence, it is not uncommon 



95 

for a person to feel a pain in the teeth 
of the upper jaw, when the disease ori- 
ginated in a tooth of the under jaw. 
But, independent of their sympathy with 
each other, the teeth have a remarkable 
one with other parts of the system. 
Thus tooth ache is often one of the ac- 
companying symptoms of pregnancy 
during the first months; though, w T hen 
the teeth are examined, they discover no 
apparent marks of disease. The treat- 
ment of tooth ache is a subject of much 
importance, and mu^t be varied accord- 
ing to the circumstances of the case ; it 
is, therefore, necessary to ascertain, 
whether it arises from caries, tartar, 
rold, or sympathetic affections. 



96 



OCCASIONAL EFFECTS 



DISEASED TEETH, 



DISEASED teeth often occasion that 
affection of the gum termed epulis, or 
gum boil : the inflammation of the tooth 
extending to the vessels at the point of 
the fang, and thence to the periosteum 
and sockets; the circulation becomes 
necessarily impeded, and the inflamma- 
tory action thus begun, ends in the for- 
mation of matter within the alveolar 
processes. While this matter is confined, 
it excites considerable pain ; the face is 
swelled and inflamed, which continues 
till the collected matter escapes. This it 
does, by eroding the socket on the outer 



97 

side* where a natural opening or ulcera- 
tion takes place ; the sore occasions a 
perpetual discharge, and the skin rises 
and becomes fungous, with a red spongy 
appearance. If the diseased tooth, which 
is the source of the evil, be removed, 
the discharge then gradually diminishes, 
and the sore heals externally : but, in 
healing, the former destruction of the 
parts, occasions a contraction of the 
skin, and a deep scar is formed, which 
to a female cannot fail to be highly disa- 
greeable, and a source of great uneasi- 
ness. When, under these circumstances, 
carious teeth are .extracted, a fleshy 
substance appears to cover their fangs, 
which extends to the bottom of the 
socket; and is that method which nature 
employs by means of granulation, (the 
effect of the healing process,) to fill up 
the cavity, occasioned by the loss of sub- 
stance, during the inflammatory action. 
Where the disease is entirely ne- 
glected, the inflammation often extends 



98 

deep into the jaw bone, and the conse- 
quence is, that a part of it separates, 
and mortification ensues. Before this 
happens, and exfoliation is accomplish- 
ed, a continual uneasiness prevails, and 
a constant discharge takes place in the 
mouth. 

As the process of mortification, or 
separation, of the parts proceeds, the 
alveolar processes are gradually left by 
the gums, and the bone, separating and 
gradually loosening, should as soon as 
the separation is completed, be taken 
away. When a gum boil forms with any 
of the temporary teeth, it requires very 
particular management; for, if allowed 
to proceed so far as to cause an exfolia- 
tion of the jaw bone, the teeth may be 
entirely destroyed. 

These circumstances point out the ne- 
cessity of early care, to prevent a malady 
of this kind. But, sometimes, instead 
of matter forming, the inflammation at- 
tending a carious tooth is of an indolent 



99 

nature, producing, at the bottom of the 
socket, a hard lump, about the size of a 
nutmeg. This appearance will continue 
without any change for months, ex- 
cept when some active irritation occurs 
from cold or other causes, which pro- 
duces considerable uneasiness and pain 
of the parts. Such tumours are always 
to be considered dangerous; for there is 
no dependence on their continuing in an 
indolent state. 

From the view taken in the preceding 
pages of the teeth, and their diseases, 
we are led to notice the parts which 
support them ; namely, the gums and the 
alveolar processes. 



100 



STRUCTURE OF THE GUMS. 



THE gums, when in a healthy state, 
are of a vermillion colour, of a semi- 
cartilaginous consistence, and highly 
vascular. They adhere firmly to the 
necks of the teeth, passing between 
them and attaching to the bony divisions 
of the alveolar processes, (which connect 
the inner and outer gums) and their ex- 
treme edges lie upon the enamel. The 
gums, which are between the teeth in 
the upper jaw, descend lower, and in the 
under jaw, are situated higher than the 
other parts. Hence, at the necks of the 
teeth they form an arched appearance. 
In their natural state they possess little 
sensibility ; but, from accumulations 
about the teeth, they acquire such an 
extreme degree of it, that the least pres- 



101 

sure occasions pain : they are liable to 
bleed, and become considerably disco* 
loured, thickened, and enlarged. In in- 
fancy, during the progress of dentition, 
should there be inflammation of the 
gums, the slightest touch produces so 
much suffering, that children will even 
refuse the breast, on account of the pain 
attending the necessary pressure of the 
nipple. On the contrary, where there 
is no inflammation, the gums are so in- 
sensible, that infants are pleased with 
sucking or biting a hard crust. In old 
age, when there are no teeth, the gums 
possess so little sensibility, that the 
chewing or bruising of food is attended 
with no pain ; and it is well known, 
that those who have lost all their teeth, 
enjoy their food much more than those 
who have diseased ones. It is clear, 
therefore, that all diseases of the gums, 
at every period of life, originate either 
from dentition, or from uncleanliness of 
the mouth, and are not peculiar to the 

K 



102 

gums themselves, as erroneously assert- 
ed by authors on this subject. The most 
frequent disease, which has been sup- 
posed peculiar to the gums, is what is 
commonly, but erroneously, called scur- 
vy, from their assuming an appearance 
similar to that of the scurvy at sea; a 
complaint always proceeding from un- 
cleanly teeth. The disorder is marked 
by the gums becoming redder than ordi- 
nary, spongy, discoloured, and bleeding 
from the slightest touch, caused by the 
fulness of the vessels. This disease of 
the gums is entirely of a local nature, 
and when neglected, is productive of 
much uneasiness and distress; for, be- 
sides their being soft and spongy, the 
mouth becomes very painful and sore, 
and the teeth so tender as scarcely to 
allow the mastication of food. Matter 
forms and oozes out near the necks or 
lower parts of the teeth, in consequence 
of the ulceration, forming between them 
and the gums. The natural arch of the 



103 

gums is thus destroyed ; they become 
uniformly straight, recede from the ena- 
mel, and thus expose the fangs of the 
teeth to whatever is taken into the 
mouth. This affection next attacks the 
alveolar processes, where absorption 
taking place, they are gradually destroy- 
ed, and thus the teeth, losing their sup- 
port, become loose, and successively 
drop out at intervals, until the person is 
rendered toothless. Persons who lose 
teeth from this cause, complain that they 
come away perfectly sound, not consi- 
dering it as the effect of uncleanliness. 

Scurvy of the gums, is a disease with 
which most individuals are more or less 
affected, under the usual method of 
managing the teeth. It is, as before 
stated, local ; and, from the very nature 
of the cause, will affect the gum on one 
side of the tooth, and not on the other. 
In its early stage, this disease is easily 
cured by the use of the dentifric appa- 
ratus. The habitual application of this 



104 

apparatus will produce a healthy action 
in the vessels, and keep the teeth clean ; 
thus preventing any recurrence of the 
cause which produced it. The brush, 
when first used, should be employed 
rather delicately, as also the waxed silk, 
until the gums harden and regain their 
arched appearance. Although the gums 
may at first become subject to a slight 
bleeding, yet in a few days, by a perse- 
verance in the treatment recommended, 
this bleeding will cease; nor will the 
slightest pain be experienced. 

When the disease has proceeded to 
such a length, that matter oozes from 
the gums, £nd the teeth feel tender and 
painful, a dental operation is the only 
remedy. 

After the operation, the above treat- 
ment will have all its influence, in pro- 
ducing the desired effect ; but there is 
an ultimate stage of this disease, where 
it does not prove altogether effectual, in 
consequence of a death taking place in 



105 

the periosteum, which covers the fangs 
of the teeth. 

Persons occasionally subject to inflam- 
mation of the gums, should clean their 
teeth often with the waxed silk ; when 
a new and healthy action will be com- 
municated to the gums, and they will 
be restored, in a short time, to their na- 
turally firm and adhesive state. By this 
uniform proceeding, the interstices will 
be kept clean, and the teeth will become 
more firmly attached in their situation. 



K % 



106 



STRUCTURE 



ALVEOLAR PROCESSES. 



THE alveolar processes, though origi- 
nally elongations of the jaw bones, do not 
belong to them, but are considered as 
appendages to the teeth. In these parts, 
as we have shewn, are deposited the first 
rudiments of the teeth, which they con- 
tinue to retain in all the stages of their 
growth, and to the fangs of which, their 
shape is gradually accommodated. Like 
the periosteum in other bones, they are 
invested with a vascular membrane, 
which is attached to the fangs of the 
teeth, and by which the latter are fixed 
in their sockets. The destruction of the 



107 

membranous lining loosens the teeth, 
and from this circumstance the single 
fanged ones drop out, whilst those that 
are double and irregularly fanged are 
retained. This dependence of the teeth 
on the membrane for their attachment, 
allows them a certain motion, intended 
by nature, in some degree to prevent 
injury, as it enables them to yield to 
the resistance occasioned by hard sub- 
stances, during the process of mastica- 
tion. This motion is most sensible where 
the fangs are inflamed ; and from the 
increased sensibility of the periosteum, 
the teeth appear as if loose to the pa- 
tient, and he is led to suppose, that the 
extraction may be performed without 
difficulty or pain, which has too often 
been proved to be a complete mistake. 

In all cases of diseased teeth and 
gums, the alveolar processes, from their 
intimate connexion with them, are more 
or less exposed to injury. The inflam- 
mation of the former extends to the 



108 

latter, which, from increased action of 
their absorbent vessels, undergo a re- 
moval of their substance. Thus their 
absorption constantly attends the loss of 
the permanent teeth, under every variety 
of age, from whatever cause that loss 
may proceed. 

Where all the teeth are lost, it may 
be observed, that the upper jaw is dimi- 
nished in length, the roof of the mouth 
loses its arch and becomes flat, and the 
under jaw is a mere piece of bone 
covered by the gums. Thus the face 
loses an inch and a half, of its former 
extent; and, from the muscles of the 
lower jaw, being obliged to act more 
forcibly to draw it against the other, are 
produced those striking and well known 
marks of old age, the deformed features, 
the hollow cheeks, the wrinkled face, 
and projection of the chin. 

Some authors, particularly Mr. Fox, 
have considered the alveolar processes 
as subject to peculiar diseases, inde- 



109 

pendent of the teeth and gums : but these 
I have never been able to trace; and 
wherever their absorption takes place, 
at any period of life, it will be found to 
have proceeded from an affection of the 
primary parts. Whenever the alveolar 
processes become diseased, the gums 
will be detached from the teeth, and will 
recede in proportion as the alveolar pro- 
cess is destroyed, the absorption gradu- 
ally advances, the necks of the teeth 
and the fangs become more and more 
exposed, and seem to those unacquainted 
with their structure, as if increased in 
length. The causes of alveolar absorp- 
tion are, continued inflammation of the 
teeth or gums, an accumulation of tar- 
tar, that affection of the gums called 
scurvy, and their diseased state arising 
from an excessive use of mercury. 

The symptoms of this state of the al- 
veolar process having commenced, are, 
the length of the teeth, the wider space 
between them, and a difficulty in chew- 



110 

ing hard substances. The teeth next be- 
come loose, and mastication is alto- 
gether impracticable. 

Besides absorption ofthealveolarpro- 
cesses, an opposite affection may be no- 
ticed. The bottom of the socket fills up, 
or becomes contracted, by which it is 
proportionally shorter, and the teeth 
are forced out, while the gum undergoes 
no change, but still retains its place; 
and the teeth continuing to advance, 
gradually lose their support, and in the 
end drop out. 

In many persons, the loss of a tooth 
is hastened by being longer and striking 
against the others ; this may be easily 
rectified, by shortening the tooth with 
a new dental instrument I have invent- 
ed for the purpose. 



Ill 



MANAGEMENT OF THE TEETH. 



THE first and most important object, 
is cleanliness of the mouth, which is the 
only preventive of disease. Of the va- 
rious causes of diseases of the teeth and 
alveolar processes, we have found that 
the greater part as enumerated by 
writers, are merely theoretical, and 
are built on no solid facts. The only 
true cause of all the diseases to which 
they are liable, is, the contact of the 
accumulation, and the action of that 
matter upon them, which forms the re- 
lics of our food and beverage, and which 
operates by undergoing the putrefactive 
process, as a deleterious poison, or cor- 
roding agent to their structure. 

Where the teeth are kept clean and 
free from such matter, no disease will 



US 

ever arise. Their structure will equally 
stand against the summer's heat, and 
winter's cold ; against the changes of 
climate, the variations of diet, and even 
the diseases to which the other parts of 
the system may be constitutionally sub- 
ject. 

This being the case, the means of 
prevention are clear and simple : name- 
ly, to avoid the accumulation of matter 
which injures their substance : and it is 
in the mode of cleaning them, that the 
whole secret of avoiding disease consists. 

The means commonly resorted to, are 
the use of the brush, joined with the 
friction of tooth powder; but, that both 
brushes and dentifrices, as they are at 
present used, however ingeniously con- 
trived or often employed, are insuffi- 
cient for the purposes of effectual cleans- 
ing, is obvious from this circumstance, 
that the teeth and gums are still left in a 
diseased state. Tooth powders, being 
generally composed of insoluble sub- 






113 

stances are acid ingredients, and evi- 
dently hurtful, both by their mechanical 
and chemical agency. 

The brushes and powders are gene- 
rally applied to the outside only of the 
teeth; and to shew the injury of these 
applications, we shall make some obser- 
vations on their composition and nature. 
The sulphuric acid, or oil of vitriol, 
from its peculiar and well known pro- 
perty, of giving a beautiful white appear- 
ance to the teeth, forms a principal ingre- 
dient in all those ruinous compositions, 
sold under the title of tooth powders, 
tinctures, or pastes. In tinctures and 
lotions, it is combined with some spiri- 
tuous or watery infusion, of an aromatic 
ature, variously coloured and scented, 
according to the taste of the composer. 
In the paste it is united with some gritty 
powder, to which a light vegetable mat- 
ter is added, when the whole is made of 
a proper consistence with honey, or 
other glutinous substance. The powders, 



114 

also, not admitting the acid in its natural 
form, have corrosive salts substituted, 
un of tarter, alum, fee <kc. 
united with powdei often cons 

of brick-dust, blended with some other 
ingredient, to colour and conceal it. But, 
besides these compositions, which are 
expressly sold for the purpose, many are 
in the habit of using substances al their 
own option for cleaning the teeth, with- 
out having recourse to these advertised 
specifics. Of this kind, soot is one; to 
which I see no other objection, than that 
it is a dirty, di-agreeable. and indelicate 
substance. Its use has, perhaps, arisen 
from the observation, that chimney 
sweepers have white teeth. This is gene- 
rally more in appearance than in reality 
when examined, it is found to be oc- 
casioned by the contrast of the face with 
the natural colour of the teeth. Another 
substance in much greater use of late 
years, for the purpose of cleaning teeth, 
uarcoal pulverized : but highly as it 



115 

is celebrated for its antiseptic qualities, 
it is very improper as a dentifrice ; for, 
however fine may be the powder to which 
it is reduced, every chemist knows, that 
the substance continues perfectly inso- 
luble. The finer indeed it is pulverized, 
the easier is the admission it finds be- 
tween the teeth and gums, where its 
insinuation, like every other extraneous 
matter, is a perpetual source of irrita- 
tion and disease ; and its constant fric- 
tion may injure the health and beauty 
of the gums ; its effect also, as a purifier 
of the breath, is very transient. Denti- 
frices similar to charcoal, are formed 
by the burning of bread, leather, betle 
nut, peruvian bark, &c. ; in their effects, 
however, they all differ little from com- 
mon charcoal : gunpowder and iron rust, 
is another composition in use, but it owes 
its quality entirely to the charcoal, as 
the nitre it contains is in too small a 
quantity to be of any use. Prepared 
alum, is another substance used for the 



116 

same purpose ; but, being a combination 
of sulphuric acid and clay, when it comes 
in contact with the teeth, it undergoes 
a decomposition, and they are conse- 
quently exposed to the action of the acid. 
The same injury arises from the use of 
cream of tartar, which, though it whitens 
the teeth, acts powerfully on the enamel. 

The best dentifrice that can be used, is 
common table salt : it is perfectly inno- 
cent, as it completely dissolves in the 
saliva, and produces all the friction that 
is necessary for cleansing the teeth. 
Nitre, is also a valuable application, both 
as it reduces the inflammation of the 
gums, and removes the tough viscid 
slime, which is then apt to collect in the 
mouth. But the cleaning of the teeth 
and gums, in order to preserve them in 
health, and prevent the attack of disease, 
can only, as we have before stated, be 
done in a proper manner, by using the 
dentifric apparatus already described. 

This is as simple in its construction 



117 

as it is easy in its application ; and its 
use, if persevered in, will preserve the 
teeth, gums, and sockets, in a healthy 
state, and render them less subject to 
disease than any other part of the body. 
The idea, that the teeth are more de- 
structible than any other part of the sys- 
tem, is founded on a mistaken opinion, 
of which we find evidence every day, ia 
bodies, which have been buried for years, 
where the teeth have been found entire 
and sound, while the other bones w 7 ere 
decayed and mouldered to dust. This is 
a sufficient proof that disease is not 
naturally entailed upon their structure, 
but the effect of carelessness, inatten- 
tion, or the want of cleanliness. 

It is in the power, therefore, of every 
individual to preserve the teeth and gums 
in perfect health, when once instructed 
in the proper method of cleaning them. 
What a world of pain and distress are 
we thus enabled to avoid by a little trou« 
12 



118 

ble and care! — the attack of serious dis- 
eases, sapping the foundation of health, 
arising from this cause, might be en- 
tirely prevented; and the stomach and 
digestive organs would also be preserved 
in their natural and regular state. By 
perfect mastication, the process of as- 
similation would be greatly facilitated, 
and the nourishment would enter the 
system in that complete form capable of 
transmitting its benefits to the most 
minute recesses of the body ; and thus 
dyspeptic complaints, which begin at an 
early period, and are the bane of those 
past the meridian of life, would not be 
so frequent as at present, nor call for 
the aid of the physican, or the constant 
use of the stomachic tincture and pill. 

When the teeth and gums are capable 
of performing their proper offices, the 
food is always relished, and health, that 
greatest of blessings, uninterruptedly 
preserved. It may, perhaps, be neces- 
sary to give some directions for clean- 



119 

ing the teeth, adapted to the varieties of 
age. 

In childhood, before the loss of the 
temporary teeth, the mouth should be 
regularly cleaned every evening, the 
relics of the food, which have been all 
the day accumulating, are thus prevented 
from committing their ravages during the 
night ; and the habit of cleanliness will 
become fixed, from being so essentially 
connected with personal comfort. The 
brush should at first be but gently ap- 
plied, and then particular care taken to 
pass the waxed silk in the interstices, 
and round the necks of the teeth, where 
lodgements of the food (the causes of 
disease) are usually formed. Warm 
water is always preferable to cold for 
cleaning the mouth, from its being a 
better solvent of the usual articles of 
their diet. But when the permanent teeth 
begin to make their appearance, then is 
the time that the greatest attention to 
cleanliness is particularly necessary. 



120 

It is a common practice with most peo- 
ple after meals, to make use of a tooth- 
pick, to remove whatever may be lodged 
between the teeth. This practice, how- 
ever, is highly to be reprobated: the 
constant use of a tooth-pick cannot fail 
to make improper openings between the 
teeth ; and when once that part of the 
gum which forms the arch, is removed 
from their interstices, a small hollow is 
made for the reception of accumulating 
matter, which, if neglected to be remov- 
ed, will, from its immediate action on the 
bone, rapidly excavate a tooth, and pro- 
duce early pain, that would never have 
existed, but for the use of so improper 
an instrument. 

Some popular writers have objected 
entirely to the use of hard brushes, and 
considered the finger as sufficient for 
cleaning the teeth, on account of its soft 
pliancy, and the gentle roughness of its 
papillary vessels. But, if this were 
sufficient, the tongue would answer yet 



121 

better; for its papillary vessels are still 
more numerous, and it possesses alsa 
greater sensibility, softness, and pliancy; 
yet, with all these advantages, it does 
not prevent the accumulation of tartar, 
which is always more abundant on the 
inside of the teeth, where the action of 
the tongue is most powerful. The same 
objection may be applied to cleaning the 
teeth with a cloth, which, though it may 
partially remove what is on the surface, 
cannot, from their inaccessible situation, 
act on those parts that it is of the most 
importance should be kept clean. 

Many people suppose that the gums 
cannot be preserved in a healthy state, 
unless they are exposed to the daily fric- 
tion of the brush. This, however, is a 
mistaken opinion ; and, indeed, if the 
friction is constantly applied in a per- 
pendicular direction, it will, by forcing 
them from the teeth, be highly injurious. 
If the gums are actually diseased, the 
application of a composition of salt and 



122 

alum, in the proportion of one of the lat- 
ter to four of the former, either in a state 
of solution, or used as a powder, will, in 
the course of two or three days, effect a 
temporary cure ; when if the tartar is 
immediately removed, and the interstices 
of the teeth kept clean, no other means 
will be necessary to keep them perfect- 
ly pure and wholesome for the remain- 
der of life. 



133 



OPERATIONS ON THE TEETH. 



SCALING. 

THE first and simplest operation on 
the teeth, is the removal of the tartar, 
termed scaling. The instruments for 
this purpose are made of various forms, 
and so constructed as to be applied easily 
to the different parts of the teeth. It is 
an operation which is not attended with 
pain ; and, for its utility, we may refer 
to the observations already made on the 
accumulation of tartar, as one cause of 
disease. In employing the instruments, 
I can with confidence say, I have never 
found a patient complain of the slightest 



124 

pain, nor even perceive the smallest 
scratch on the enamel, after the tartar 
had been removed. This is prevented 
from the lightness of hand, with which 
the instrument is conducted over the sur- 
face of the teeth j a dexterity acquired 
only by practice and experience. 

Instead of performing this operation 
by means of instruments, some dentists, 
from a desire to make the teeth appear 
white, have employed chemical solvents. ■ 
But, as the tartar contains the same 
principle of solidity, as the teeth them- 
selves, — namely, phosphate of lime and 
fibrina, whatever acts in destroying the 
tartar, must also act in injuring the 
teeth : such means, therefore, are to be 
strongly condemned, and will never be 
employed by an operator of any re- 
spectability. The benefit derived from 
the removal of tartar, is not to be esti- 
mated according to its quantity, but ac- 
cording to the situation in which it is 



125 

placed ; for, if a very small quantity has 
insinuated itself in the interstices, or 
round the neck of a tooth under the gums, 
the removal of it, is of more importance 
to the patient, than a greater quantity 
on the crown. This fact is proved by 
daily observation ; for teeth become 
loose, and fall out early, with very little 
tartar upon them. 

A popular prejudice prevails against 
scaling the teeth, from its having been 
observed, that, after such an operation, 
they tend more rapidly to decay ; a cir- 
cumstance easily explained. For, while 
tartar is confined to the crown of the 
teeth, so as not to interfere with the 
gums, however disagreeable in appear- 
ance, it acts as a complete preservative 
against the attack of caries. This na- 
tural protection, therefore, being re- 
moved, it will be easily seen why, if the 
teeth are again neglected, their liability 
to decay should be increased. This ef- 

M 



126 

feet, however, is completely prevented* 
by the constant use of the dentifric ap- 
paratus, which will also supersede the 
necessity of future scaling. 



EXTRACTION OF TEETH. 



THIS is an operation which always 
creates some little alarm to the patient, 
and is sometimes attended with difficulty 
and danger ; but, in this, as in many sur- 
gical operations, the ease and safety 
with which it is executed, will depend 
on the skill of the operator; though, 
for the consolation of patients, my ex- 
perience warrants me in asserting, that 
extraction is much oftener resorted to 
than is necessary. Whenever a tooth is 
painful, it is advisable to have it ex- 
amined, and an endeavour should be 
made to remove the malady by palliative 
means j but, if it prove carious, the dis- 
eased part should be removed, and the 
tooth repaired. Indeed there is no ne- 
cessity for having recourse to this dan- 



138 

gerous expedient, even if the crown be 
entirely decayed ; for the fangs of the 
teeth will always admit of engrafting, 
on a plan I have for years so success- 
fully practised. Extraction therefore 
can only be necessary, either to prevent, 
or remedy, irregularity in the arrange* 
ment of the permanent teeth of children, 
or, in some diseases of rare occurrence 
in the adult, as in neglected cases of the 
antrum maxillare, as well as, where the 
diseased state of their fangs has, from 
neglect, terminated in what is called an 
ulcerated tooth. In all other cases it 
is to be opposed, and is a wanton outrage 
on the unhappy individual, who, from the 
effect of pain, is brought to submit to 
this harsh and often unavailing mea- 
sure. But, independent of the little ne- 
cessity for such an operation, we know 
that it has sometimes been attended 
with the most serious and fatal conse- 
quences. 



129 

Even in the most favourable case, 
there must be a fracture of that part of 
the socket where the fangs are situated; 
and if the alveolar process is firmer 
than usual, and does not yield to the 
power of the instrument, the fracture 
may be extended through the alveolar 
processes of several teeth, and the jaw 
bone be exposed to a most serious injury, 
the effects of which the patient may re- 
tain for life ; and the formation of matter 
taking place, several of the contiguous 
teeth will be rendered useless. But, 
though the operation may be success- 
fully performed, a dangerous haemorr- 
hage often follows. Some patients have 
suffered a continued bleeding for twenty- 
four hours, and their lives have been 
with difficulty preserved, while other 
cases have ended fatally from this cause 
alone, in spite of all the boasted powers 
of styptics. 

This alarming effect of extraction 
arises from the artery not always con- 

M2 



130 

tr acting after the removal of the tooth, 

either from the injury done to the parts, 
or from its being of a larger size than 
usual, and the coagulum that is formed 
not being sufficient to prevent the effusion 
of blood. As these consequences cannot 
be foreseen, the operation is a more 
serious one than is commonly imagined ; 
and should,, therefore, never be trusted 
to the rash or ignorant. Much likewise 
depends on the state of the patient's con- 
stitution at the time of extraction. In 
some persons we find so strong a dispo- 
sition to gangrene or mortification, that 
the slightest scratch or cut will produce 
a tendency to it. In such habits the ex- 
traction of a tooth,, aided by the putre- 
factive process arising from a diseased 
state of the sums, will easily excite in- 
flammation. when either a tedious ulce- 
ration and exfoliation of the parts will 
ensue, or else the patient will be cut off 
by a mortification rapidly extending its 
effects to the jaws, face, and throat. 



131 

A dreadful instance of which lately oc- 
curred in Guy's Hospital, where a pa- 
tient died solelv in consequence of the 
extraction of a tooth. 

For these reasons I strongly object to 
the extraction of teeth in all cases, but 
those specified in the preceding observa- 
tions; where extraction, however, is ad- 
visable, I employ an instrument similar 
to that of an engraver's tool. In this I 
differ from all other operators ; for they 
uniformly prefer the key instrument, so 
long in use. It is true, that it has un- 
dergone several alterations, and has re- 
ceived some improvements; but the prin- 
ciple of it, even in its most improved 
state, remains the same, and cannot be 
too strongly reprobated. 



132 

MENDING OR CAPPING 

DISEASED TEETH. 



THIS is an operation which is rarely 
attempted by dentists ; and it must give 
no little satisfaction to those having ca- 
rious teeth, to know they can be com- 
pletely repaired by a new mode of ope- 
rating peculiar to myself. 

The carious teeth are thus rendered 
ornamental and useful through life, and 
every complaint prevented which arises 
from imperfect mastication. An acci- 
dental circumstance first convinced me 
that a part of a tooth might be supplied, 
and that in so perfect a manner as com- 
pletely to escape detection. 

The frequent performance of this ope- 
ration has enabled me to execute it with 



133 

success, in situations where I did not at 
first conceive it practicable. It is at- 
tended with scarcely any pain ; and the 
discovery will, in most cases, supersede 
the necessity of extraction. 

A knowledge of the evils which may 
result from a carious tooth, even if un- 
accompanied by pain, should influence 
every person, on its first discovery, to 
seek the proper remedy ; for by cap- 
ping the diseased tooth, the lodgement 
of food, occasioning the putrefactive 
process, is prevented, and the conse- 
quent taint of breath removed ; the pro- 
gress of decay is arrested, and the pain 
arising from tooth ache, or any other 
cause, completely done away. But where 
the teeth are painful, and attended by 
inflammation of the gums and sockets, 
this operation should be suspended till 
the painful symptoms subside ; for the 
cavity of an inflamed tooth is then so 
sensible, that the accidental introduction 
of any substance will excite the most 



134 

acute pain: it is therefore advisable, 
first to diminish the increased action, 
which may be done by filling the carious 
tooth with cotton, dipped in an infusion 
of oil of cinnamon and gum camphor; 
and, as soon as the tenderness or pain 
is removed, then should the operation 
of capping be performed. 

In cases where the crown of a tooth is 
entirely decayed, I have found means of 
supplying the deficiency without having 
recourse to metallic aid, or ligatures. 



135 



ARTIFICIAL TEETH. 



THE utility and importance of this 
invention may be fully appreciated, when 
we consider, that by the loss of teeth, the 
youthful countenance acquires all the 
character and deformity of age; the 
natural expression of the features is 
changed, mastication impeded, and the 
power of correct enunciation entirely 
destroyed. 

My mode of supplying teeth is as dif- 
ferent from any employed by my prede- 
cessors, as it is far superior to all that 
are at present known. They are formed 
from a substance warranted not to change 
its colour, are rendered perfectly durable, 
contrived so as to baffle detection, com- 
bining ease with beauty, and are, in all 



136 

inspects, as efficient as those of the na- 
tural set. 

On this branch of the dental art much 
labour and ingenuity have been bestow- 
ed ; and it is the exactness with which 
artificial teeth are adapted to the mouth, 
and the ease with which they can be 
worn, that constitutes their chief excel- 
lence. The mode of supporting teeth, 
by means of ligatures, round the con- 
tiguous ones, I very early found suffi- 
cient reason to discontinue in my own 
practice; nor is the other method of 
fixing the artificial crown by means of 
a gold or silver pivot, as was recom- 
mended and practised by Mr. Fox, lia- 
ble to less objection ; as, on this plan, 
the pivit soon wears away the fang, the 
artificial crown becomes loose, and will 
at last drop out. This has been gene- 
rally considered as the fault of the ope- 
rator, in not adapting such teeth with 
sufficient nicety to the fangs; but the 
blame attaches rather to the principle 



137 

than to the dentist; for it is impossible 
that a pivot, made from a harder substance 
than the bone of a tooth, can be used with- 
out the latter sustaining injury from the 
constant friction. The same objection 
may be applied to the fastening artificial 
teeth by clasps, or springs, round the 
necks of the natural teeth, or securing 
them by means of fine wire, or Indian 
grass ; for, in whatever way it is appli- 
ed, it tends to destroy the periosteum, 

But, besides these inconveniences aris- 
ing from the use of artificial teeth, se- 
cured by ligatures, pivots, clasps or wire 5 
a still greater objection is the taint the 
breath receives from the particles of 
food, which remain about the teeth, and 
which, from the nature of these contriv- 
ances, appears to be unavoidable. 

The author has long abandoned this 
destructive practice, and is able to per- 
form the operations in such a manner, 
as to render artificial teeth completely 
secure, without either of the above me- 

N 



138 

ihods. This, he has no doubt, will be 
a matter of astonishment to those, who 
are acquainted only with the common 
mode of operating; but he is ready to 
convince the most sceptical on this sub- 
ject. Incredible as it may appear, the 
witnesses of his practice, both abroad 
and in this country, will prove the de- 
cided superiority of the Farmltjan Sys- 
tem. His method, he is satisfied, is 
entirely new in this country, and is con- 
sidered one of the greatest improvements 
in the dental art. 

Where the teeth are mostly gone, in 
both or in either of the jaws, the method 
is to form an artificial set, by first 
taking a mould of the risings and de- 
pressions of every point along the sur- 
face of the jaw, and then making a cor- 
responding artificial socket for the 
whole. 

If this be accurately fitted, it will, in 
most cases, retain itself sufficiently firm, 
by its adhesion to the gums, for every 



139 

purpose of speech and mastication. K 
this adhesion cannot he rendered suffi- 
ciently complete, from the irregular form 
of the jaw, then it must he supported by 
springs. On its first application, such 
a mechanical apparatus feels unpleasant, 
but habit soon reconciles the wearer to 
its use. The gums become hard, and 
the sensibility of them nearly oblitera- 
ted, so that at last the person feels un- 
easy without them. 

Artificial teeth are commonly made 
from the tusk of the hippopotamus or 
sea horse, which has been preferred for 
its whiteness, durability, and fine ena- 
mel. The chief objection to its use, is, 
that it does not resemble the human 
teeth in colour. This difference is more 
apparent, when placed by the side of a 
natural tooth, than when the entire set 
is made from the same substance. 

Artificial teeth have likewise been 
formed of a paste, termed mineral teeth ; 
they are composed of baked earth, 



140 

covered with an enamelled flux, and co- 
loured to imitate nature. This sub- 
stance is best suited to entire sets, but 
objections arise to such teeth, as they 
are easily broken, and do not assume 
the healthy appearance of the human 
teeth. Neither have they ever been formed 
so as exactly to imitate nature, but are 
easily discovered to be artificial machi- 
nery ; and many improvements are still 
wanting to render them complete. Hav- 
ing succeeded in supplying the loss of 
teeth, as already stated, without the aid 
of ligature or any metallic substance, 
and, aware of the prejudice prevailing 
against the use of natural teeth for this 
operation, I succeeded in discovering a 
substitute, possessing all their advan- 
tages of form, durability, and colour, 
in the teeth of certain quadrupeds smaller 
than the sea horse ; the beauty of whose 
enamel is superior, and whose form re- 
quires little or no alteration. This in- 
vention I have now successfully employ- 



14* 

ed for years ; and my practice requires 
only a comparison with the operations 
of other dentists, to estimate fully the 
importance of such an improvement. 

In all cases of artificial teeth, an at- 
tention to cleanliness is indispensably 
necessary ; for they, as well as the hu- 
man teeth, unavoidably accumulate tar- 
tar ; and from the particles of food ad- 
hering to them, they become highly dis- 
agreeable. They should be frequently 
cleaned with warm water; and, by 
means of the dentifric apparatus, they 
may be rendered equal in appearance* 
wholesomeness, and durability to the na- 
tural set. 



142 



TRANSPLANTING OF TEETH, 



THIS is a painful operation, and not 
often attended with the desired success. 
It was once a popular practice ; and is 
performed by completely extracting the 
diseased tooth, in whose place another 
is to be introduced. The tooth to be 
substituted, is then to be removed from 
the mouth of a person, previously pro- 
vided for this purpose, and instantly 
transferred to its intended situation, 
where it is properly fixed till it unite 
firmly to the socket. 

This operation is, at best, but limited, 
being confined to the front teeth, or those 
having single roots. 

The practice was first suggested, and 
acted upon, by the late Mr. John Hun- 
ter ; it continued a few years after his 



143 

death, but is now, for strong reasons, 
entirely given up ; for, first, it did not 
always succeed, nor could it be expected ; 
facts proving that when teeth are ex- 
tracted by mistake, they do not always 
become firm again, even when immedi- 
ately replaced. Much less can a tooth, 
belonging to another person be expected 
to become fixed, when inserted in a 
socket of unsuitable dimensions. 

Besides, after submitting to the ope- 
ration, and undergoing, for weeks, all 
the penance of a fluid regimen, and even 
where a transplanted tooth, under the 
most favourable circumstances, has fast- 
ened, experience has shewn that its du- 
cation is limited to a very few years. 

To this may be added the turpitude of 
disfiguring; one person for the sake of 
another j and the danger of introducing 
disease, which Mr. Hunter has laboured 
so strongly, but unsuccessfully, to op- 
pose. He admits, however, that this 
operation has occasionally produced dan- 



144 

gerous symptoms ; but that these arise 
from the principle of irritation alone, ex- 
citing deranged sympathies. But what- 
ever may be the cause, the consequences 
have been, in many instances, unplea- 
sant and alarming ; and, if the mere ir- 
ritation of a foreign body, applied in 
this way, is sufficient to produce them, 
it is a strong reason for laying the prac- 
tice aside, whether it is capable of intrc^ 
ducing infection and general disease info 
the system or not. 



145 



IRREGULARITIES. 



TEETH. 



IN all cases of irregularities, during 
the shedding of the teeth, the treatment 
to be observed, is to remove the obstruct- 
ing temporary teeth, and then to ap- 
ply pressure, in the most convenient 
manner, upon the irregular tooth, in 
order to direct it into its proper situa- 
tion. But parents, unfortunately, do not 
in general, perceive the necessity of 
having recourse to professional aid, until 
the irregular growth of their childrens 
teeth, is so far increased as to amount 
to a manifest deformity. Where suffi- 
cient room is not made for the perma- 



146 

nent teeth, by the timely removal of the 
temporary set, irregularities of the for- 
mer are often met with ; and where 
these irregularities are allowed to pro- 
ceed and become fixed, it is often a mat- 
ter of difficulty, and sometimes of im- 
possibility, to rectify them. 

Thus, where the permanent teeth are 
large, and the jaw bones have not grown 
sufficient to admit of their enlargement, 
in a regular manner, they crowd and 
over-lap each other. In the same man- 
ner the central incisores of the upper 
jaw are often pressed forward, and ren- 
dered so prominent, as somewhat to re- 
semble in shape the mouth of a rabbit. 
When the space of the jaw is not suffi- 
cient for the regular arrangement of the 
teeth, some must then be considered as 
superfluous ; and it will be necessary to 
remove one or more of the bicuspides 
from each side of the jaw, before the 
fangs are formed, to give room to the 
vest ; the incisores must then be gradu- 



147 

ally forced into their proper situation. 
The occasional pressure of the finger 
and thumb, if attended to, before age has 
given too much firmness to the jaw, will 
invariably bring the teeth into their 
proper places, without the necessity of 
having recourse to continued pressure 
by means of instruments adapted to the 
arch of the mouth, as recommended by 
Mr. Fox. 

But, in some cases, the cause of irre- 
gularity arises not from the want of 
space in the jaw, but from the protru- 
sion of supernumerary teeth, which are 
generally of a deformed shape, and some- 
what resembling the cuspidati. These 
protrusions usually take place in the 
upper jaw, and if inside, they are in front 
of the jaw, or when without, near the 
molares ; and are always very conspicu- 
ous, and should, as soon as their growth 
will admit of it, be extracted. 

But the most frequent irregularity, 
which occurs in the appearance of the 



148 

teeth, is, where one is longer than the 
other, or where they have ragged edges. 
This often takes place in the edges of 
the front teeth, which are so irregular 
as to resemble a saw. 

These irregularities, in order to avoid 
inflammation in those parts of the mouth 
that come in contact with them, it will 
be necessary to remove, which is easily 
effected by the improved dental instru- 
ments, which cut much faster than the 
file, without producing any unpleasant 
sensation. 

No injury will attend this operation; 
on the contrary, it will improve the 
shape, and prevent any further crack- 
ing, or separation of the enamel. The 
application of the file has heen consider- 
ed injurious, by those who suppose the 
removal of part of the enamel, to occa- 
sion the decay of the teeth. But a partial 
loss of the enamel, or even a larger por- 
tion of the tooth, while the cavity re- 
mains untouched, will never occasion 



149 

its decay. This is confirmed in those 
cases where the enamel is broken by 
accident, as well as by the operation of 
filing, for the purpose of removing the 
carious part, which preserves the rest 
of the tooth entire. The truth of this 
observation will further appear from a 
practice that obtains among savages; 
for, it is well known, that the Abyssinian 
negroes remove the corners of the cutting 
edges of the incisores, so as to give 
them a pointed appearance ; and, by not 
interfering with their cavities, such 
teeth receive no injury whatever, from 
the operation of the file : the Malay 
Indians likewise file the incisores of the 
upper jaw, in a direction across their 
anterior surface, giving them the ap- 
pearance of being fluted; but, by this 
operation, the cavities of the teeth be- 
come exposed, and caries accordingly 
soon takes place. The chief objection, 
however, of patients, to the operation of 
filing arises from the unpleasant sen- 



150 

sation it produces : — but here the fault 
attaches rather to the dentist, than to the 
instrument ; and I have the satisfaction 
to state, that, in the method invariably 
adopted by myself in the use of this in- 
strument, but little inconvenience is ex- 
perienced, much less any excitement of 
pain. 



151 



FRACTURES OF THE TEETH. 



THE teeth are as liable to injury 
from accidents as other bones, and the 
incisores of the upper jaw are, from their 
situation the most exposed to them. 
Boys, in their quarrels or amusements 
with each other, frequently have their 
front teeth fractured by blows received 
on the mouth. Falling on the face has 
been attended with the same effect, as 
also the attempt to catch a cricket ball, 
and many other circumstances of the 
same kind. Even the mastication of 
hard substances, when the muscles of the 
jaw are in strong action, will produce 
the fracture of a sound tooth. 

In such accidents, the treatment must 
be regulated by the extent of the injury. 
If the fracture is confined to the point of 



152 

the tooth, nothing more will he required, 
than to make it smooth and equal with 
the other surface, by a fine file; and, 
as the tooth has not previously been in 
a state of disease, there will be no dan- 
ger of the attack of caries. But, if the 
injury extend into the cavity of the 
tooth, it will then become tender, and 
for some time become subject to occa- 
sional fits of pain ; but nature generally 
repairs this mischief by a fresh deposit 
of bone, in the cavity which defends the 
nerve, and often prevents any further 
trouble for the remainder of life. 

Where fractures are of a more serious 
nature, and the cavity is completely ex- 
posed, then the age, and other circum- 
stances, must regulate the treatment. 
If it occur at so early a period of life as 
fifteen years, the best plan is, to extract 
the fractured tooth ; and, at the age of 
maturity, the teeth will be found to have 
approached so near to each other, as to 
render the loss scarcely perceptible. 



153 

This treatment applies only to fractures 
of the permanent teeth ; for such acci- 
dents happening to the primary set, are, 
from their temporary duration, of little 
consequence ; when the injury occurs at 
an advanced period of life, the loss is 
very serious, not only from its unseemly 
appearance, but also from its occasion- 
ing a defect in the speech. If assistance, 
however, can be procured before inflam- 
mation has commenced, the tooth may 
be easily repaired. 

If a tooth is completely knocked out, 
and the alveolar process is not injured, 
it should be immediately returned to its 
place, and secured to the adjoining teeth, 
when it will fasten in a very short time. 

Where a fracture is of a very serious 
nature, and the person is anxious about 
the future appearance, the remainder of 
the crown may be cut away, and a new 
one fixed to the fang. 

If the blow or accident only loosen 
the tooth, it will in a young subject, 
o 2 



154 

readily fasten again, though it is apt to 
lose its colour, and so assume a bluish 
tinge ; but, where a tooth is thus loosen- 
ed in more advanced life, it rarely fas- 
tens, for the fang becomes deceased, 
which communicates to the socket, and 
then the tooth becomes so loose as to re- 
quire extraction. 

But, in all cases, of accidents, where 
the alveolar processes have suffered, the 
fastening of the tooth or teeth can never 
be depended on; for inflammation is 
apt to arise, matter forms in the socket, 
and nothing but extraction will give ease 
to the patient. 



155 



CRACKS OF THE ENAMEL, 



THESE are confined to the incisores, 
and are mostly caused by the too fre- 
quent or violent action of their cutting 
edges against each other. This arises 
in a great measure, from the loss of the 
back teeth, when the incisores are not 
only more frequently used in the act of 
mastication, but are necessarily brought 
into contact by a stronger muscular 
power. This action upon each other, oc- 
casions them to assume an appearance 
something like caries ; but the teeth do 
not, as in caries, become softer, nor 
does it commence with inflammation, 
but it consists solely in the enamel part- 
ing from the bone, and it proceeds no 
further than to effect the exterior sur- 
face of the teeth. 



156 

Whenever such cracks or separation 
of the enamel appears, it is advisable, in 
order to stop its progress, to cut and 
file away the part that appears thus dis- 
figured, taking particular care to leave 
the cutting edges somewhat rounded. 



157 



DENUDING PROCESS. 



THIS disease, at first, begins by a 
wasting of the enamel, by which a small 
portion appears as if scooped out, or 
filed away. This wasting continues to 
increase till the bone is exposed, during 
which time the tooth becomes discolour- 
ed, assumes a brownish hue, is smooth 
and polished, and will often continue so 
for years. In some teeth the anterior 
part of the enamel has, in this way, 
been entirely removed, but without any 
exposure of the natural cavity, and the 
bony part has remained prominent as 
before. It is not unfrequent for the 
teeth in this state to be very tender, and 
susceptible of the slightest application 
of heat or cold. In the whole extent of 



158 

my practice, I never met with this dis- 
order, whose cause I could not safely 
attribute to the use of acids in the den- 
tifrices that were employed. 



159 



WEARING OF THE TEETH. 



THE natural effect of mastication is, 
to wear the teeth by the friction and at- 
trition with which it is accompanied. — 
Thus, where the incisores, when the 
mouth is closed, are so situated, that 
they meet each other at the cutting 
edges, instead of those of the upper jaw 
over-lapping the corresponding ones of 
the under set, mastication cannot be 
performed without a more extensive la- 
teral motion of the jaws, which, of 
course, occasions a greater friction, by 
which the teeth gradually wear away. 

This circumstance always takes place 
in the front teeth, where the back ones 
have been lost in the early part of life, 
and often the whole crowns have been 
removed*. The effect of this process is 



160 

to render the teeth tender, and occasion- 
ally subject to pain ; this tenderness 
and sensibility of the fangs, however, 
are gradually lessened by the ossific 
matter that is deposited by the vessels, 
until the whole cavity is completely ob- 
literated. This deposit of ossific matter 
led Mr. Hunter erroneously to believe, 
that the teeth were extraneous bodies, 
with respect to a circulation through 
their substances ; but, he justly observes, 
that they rarely decay after a person 
has passed fifty years of age ; because 
the bony or osseous matter of the tooth 
has then acquired a degree of firmness 
of texture, nearly equal to the enamel 
itself. 



161 



MORBID GROWTH 



OF THE 



GUMS. 



THE irritation produced by decayed 
teeth, on the circulation of the gum-ves- 
sels, is often the cause of a preternatural 
growth of the gums, by which excrescen- 
ces or tumours form on them of various 
sizes. Carious stumps, are the most 
frequent source of this morbid growth ; 
for, if the socket is not close at the bot- 
tom, a protrusion takes place, which 
makes the edges of the gums grow irre- 
gularly over it, and thus, by the pres- 
sure of the sharp edges of the stumps, a 
constant soreness and inflammation is 
kept up j the soft parts assume a diseased 



162 

action, and the gums rapidly increase in 
size. An enlargement of this kind, will 
often equal the size of a walnut and no 
cure can take place, till the cause or ir- 
ritating edges be removed ; on this being 
accomplished, and the fang repaired, the 
fulness of the vessels is taken off by the 
haemorrhage accompanying this opera- 
tion, while the morbid growth, or en- 
largement from its fungus nature, soon 
decays, and the gum is reduced. At 
other times, tumours form on the gums 
without any evident cause, and uncon- 
nected with the state of the teeth. This 
is the cause, also, in other parts of the 
body, wherever a soft vascular stricture 
prevails. Such tumours are of a firmer 
consistence than where they arise from 
decayed teeth, resembling the gum in its 
healthiest state. 

When troublesome, their removal 
should be attempted either by excision 
or ligature. Wherever a ligature can 
be applied, it is the safest method j for, 



163 

in performing excision, the operation 
from the vascular nature of the tumour 
is always attended with danger, on ac- 
count of the great loss of blood, which 
ensues from the impossibility of taking 
up the vessels, or of employing any 
other means of stopping the effusion, 
than the actual cautery. Other tumours 
of a different nature form on the gums, 
which are distinguished by their parti- 
cular softness and disposition to bleed. 
Such tumours are generally the conse- 
quence of a diseased jaw bone ; and, as 
no cure can take place without the re- 
moval of the cause, the operation above 
mentioned, either by excision or liga- 
ture, has, in these cases, generally fail- 
ed. If however, they arise only from 
the fangs of the tooth being in so very 
diseased a state as to have occasioned a 
destruction of part of the alveolar pro- 
cess, then a cure can be effected only 
by extracting the diseased tooth ; and if, 
on examining the socket, it be found 



16* 

rough and denuded of its periosteum, 
a weak solution of nitrous acid applied 
to it, with lint, and frequently renewed, 
will cause an exfoliation of the diseased 
jaw bone, and the tumour will be remov- 
ed. But there is nothing, from which 
the gums are more apt to suffer, both 
in their healthy consistence and general 
texture, than the use of mercury, em- 
ployed in various diseases. By in- 
creasing the active powers of the saliva, 
as a solvent, the solidity of their compo- 
sition is gradually destroyed, and a 
spongy state takes place, giving a dis- 
position to bleed on the slightest touch : 
the weakness of their texture detaches 
them from the teeth and socket; and 
thus the bony parts are left loose, and 
totally deprived of every kind of support. 



165 



ARTIFICIAL PALATES. 



FORMERLY, when the treatment of 
diseases, was not so well understood as 
at present, the loss of the palate, and an 
opening between the mouth and the nose, 
was a frequent misfortune, producing a 
defect of speech, as well as an inconveni- 
ence in the taking of food. 

This defect, however, from the im- 
provements in medical practice, is now 
but of rare occurrence ; and is confined 
to those unfortunate cases where medical 
aid has been deferred too long. A sub- 
stitute is then required to fill up the 
opening formed by the loss of the na- 
tural palate, between the mouth and 
nose ; and this substitute consists of a 
thin plate of gold or silver, made con- 
vex, so as to cover the orifice, and se- 
p 2 



166 

cured in its place by a piece of sponge 
connected with it. Many ingenious im- 
provements have taken place in this con- 
trivance; and in the hands of some skil- 
ful dentists, they are applied with such 
a nicety, and so admirably fitted to the 
part as to require no sponge, nor any 
other of those additional aids formerly 
employed. 

Whenever an artificial palate is worn, 
cleanliness must be strictly enjoined: 
and, on this account, it will require to 
be frequently removed. 



167 



LIGATURES OF THE TEETH. 



THIS is an application generally 
used by dentists, as an artificial support 
to the teeth, till they become firm again, 
after being loosened, either by a blow, 
by the accumulation of tartar, or by the 
absorption of the alveolar processes. 
This practice, however, should never be 
employed to any extent; for, if the liga- 
ture is made with such a degree of tight- 
ness as to give a proper support, it must 
loosen the sound teeth it passes over, 
and thus increase the evil it is intended 
to remedy. The fastening of a tootb 
when loose, is entirely the effect of a 
process of nature, and depends on the 
healthy condition of the appendages of 
the teeth, to enclose and root it again in 
its situation. 



168 

In cases of an accidental blow, where 
the parts have not suffered from disease* 
ligatures may be successful as a tem- 
porary support ; but where disease has 
occasioned an absorption of the alveolar 
processes, or where the accumulation of 
tartar has detached the gum, and per- 
haps even the periosteum, this success 
is not to be anticipated. Ligatures, 
therefore, if at all admissible, should be 
but seldom employed. 

In cases of accident, after the loose 
tooth is properly replaced, it will be 
better to keep the patient on a fluid 
diet till it fastens, than to employ any 
means of support which may injure the 
rest. Even where ligatures are applied, 
they seldom continue fast for any length 
of time, but often break or become loose, 
from the solvent properties of the saliva 
acting upon them ; when the operation 
must be repeated, and thus give the pa- 
tient much unnecessary trouble. 

For these reasons I have, in my own 



169 

practice, avoided the use of ligatures, 
whether formed of silk or metallic sub- 
stance, and employ, what I conceive, a 
far preferable method for answering the 
same purpose. 



170 
DISEASE 

OF THE 

MAXILLARY SINUS 

OB, 

ANTRUM MAXILLARE. 



WHEN the inflammation of the teeth 
and gums of the upper jaw is long con- 
tinued and very considerable, whether 
proceeding from accident, or from th& 
natural effects of disease, it is often 
communicated to the lining or investing 
maxillary sinus. 

This affection is distinguished by a 
deep throbbing pain, which appears to be 
seated at the roots of the molares of the 
upper jaw. In its progress, it affects 
the eye, nose, and ear ; and the in- 



171 

flammation proceeding to suppuration, 
matter accumulates in the cavity, and, 
having no vent or passage, destroys, by 
its corroding effects and pressure, the 
neighbouring bone. Where the symp- 
toms are more moderate, matter will 
often remain in a confined state, for a 
considerable time, without producing 
much injury. 

As soon as the symptoms of this dis- 
ease are discovered, (a fact exceedingly 
difficult to ascertain till matter is actu- 
ally formed,) the great point is to give 
it a free opening or discharge. The 
readiest way of doing this, is to extract 
the middle grinder or molares, the 
situation of which is immediately under 
the maxillary cavity, and afterwards to 
pierce through the socket with a small 
trochar to the sinus. The opening thus 
made should be preserved for some time, 
and detergent applications occasionally 
injected with a syringe, till every ap- 
pearance of discharge subsides. 



m 

This state of the antrum, independ- 
ent of the diseases of the teeth, has often 
been produced by the lodgement of 
worms or insects. They are conceived 
to have had their ovse, or eggs, deposit- 
ed in the nostril, or to have been drawn 
in with the breath into the nose, and 
thus conveyed into the antrum. 

Their removal, when discovered, is to 
be accomplished by the operation above 
jnentioned, and the use of oily, or other 
injections, till they are entirely exter- 
minated. 



We have thus enumerated the various 
diseases which affect the teeth, the gums, 
and the alveolar processes ; and, with 
respect to the latter, in concluding we 
may observe, that while their growth 
lengthens the countenance of the infant, 
and gives its first and early character 
of youth, so, on the other hand, as we 



173 

have before repeatedly noticed, it is the 
loss of these processes by the destruction 
of the teeth, which gives the character 
of advanced life, or old age ; for, by this 
loss, the chin necessarily approaches 
nearer to the nose, the lips turn in, and 
the skin, being more loose, naturally 
falls into wrinkles ; as may be seen in 
figure 2, in the frontispiece, 



1?4 



PHYSIOGNOMY 



TEETH. 



THE importance of the teeth, in 
speech, in mastication, and in giving 
symmetry and expression to the counte- 
nance, has been already sufficiently no- 
ticed. 

But, it has been attempted to carry 
their importance further, in supposing 
these organs to exert an influence in the 
formation of the human character; and, 
for this doctrine, there exists perhaps 
some slight foundation, but certainly not 
to that ridiculous extent contended for 
hy authors, whose imagination on their 



175 

favourite subject appears so completely 
to have misled their judgment. 

That the state of the mind is often 
discovered in the countenance every one 
will admit; but the countenance is made 
up of parts in a high degree flexible, 
which vary their motions and expres- 
sions with every changing impulse of 
the soul. Where then the mind broods 
over any particular passion, or yields to 
one continued train of thought or feel- 
ing, the expression of such mental affec- 
tion may remain fixed in the counte- 
nance, and give a determined and de- 
cided character to the features. 

The teeth, on the contrary, are fixed 
bodies ; they can receive no change 
from the influence of the mind, and they 
merely fill up, or give that finish to the 
countenance which can admit of no other 
change, as far as these organs are con- 
cerned, than what will arise from their 
loss. 

In the ingenious system of Lavater, 



176 

they have met particular notice; and, 
from the appearance of the teeth and 
projecting chin, he has drawn many 
plausible conclusions. 

« Thus, small short teeth have been 
considered as denoting a weakness of 
character and constitution ; and, though 
such have been observed in many per- 
sons of extraordinary strength, yet, in 
those persons, they are seldom of a pure 
white. Long teeth are considered as 
sure signs cf weakness and pusillani- 
mity. White clean well arranged teeth, 
visible on -opening the mouth, but not 
projecting, nor always seen, have been 
esteemed marks of good, acute, honest, 
candid, and faithful men. Where, in 
such persons, they appear otherwise, or 
are foul, uneven, and ugly, it is either 
the effect of sickness, or some mental 
imperfection which has changed them. 
Short broad teeth, standing close toge- 
ther, are the characteristics of tranquil- 
lity, firmness, and strength. Persons of 



177 

a melancholy habit, have seldom teetli 
well arranged, clean, and white." 

Such are the maxims laid down by 
Lavater ; but they have no foundation 
in truth. The size and shape of the teeth 
we have seen, are originally developed, 
and arrive at perfection long before the 
anental qualities are established, and the 
mind acquires its character. 

But, though the teeth can have no ap- 
parent influence on the mental qualities 
of individuals, yet a considerable differ- 
ence is visible in their appearance in the 
inhabitants of different countries j and, 
in this point of view, they may be con- 
sidered indicative of the character of 
nations. Thus, the Spaniards are dis- 
tinguished in general for their well ar- 
ranged teeth. The Tartars, for their 
long and separated ones ; and the Hot- 
tentots, for their extremely white ones. 

Even the ideas of beauty, in respect to 
the colour of the teeth, differ in different 
countries. In Europe, and in civilized 



178 

society, the degree of whiteness consti- 
tutes their perfection. But, amongst 
savage tribes, black is preferred, in or- 
der to make them differ from the brute 
creation. Thus, the women of the Ma- 
rian Islands blacken their teeth ; — the 
same is done by the Tonquinese and 
Siamese, and by the inhabitants of Suma- 
tra and Malacca. In Java, this distinc- 
tion is confined to the married women, 
as a mark of greater respect ; while, in 
the other parts of the East India Island?, 
the two central incisores of the upper 
jaw are often gilded, and the adjoining 
teeth made of a black colour. 

In the East Indies, particularly in 
Hindoostan, the care of the teeth among 
the Bramins is made a part of their re- 
ligious rites. As soon as they rise in 
the morning, their teeth are rubbed for 
an hour with a twig of the fig-tree. 
During this operation, their prayers are 
fervently addressed to the sun, invoking 
the blessing of heaven on themselves 



179 

and families. This practice, it is pre- 
sumed, is coeval with their religion and 
government ; and certainly nothing can 
shew their high regard for cleanliness, 
and particularly for the purity and beau- 
ty of the mouth, than by making it both 
a law and religious duty. The white- 
ness and regularity of the teeth seems 
to have been considered by their poets* 
as one of the principal charms of a mis- 
tress. Hence, the epithets of « sparkling 
teeth: teeth, white as the cunda blos- 
som/' In other places of India, the 
teeth are made of a reddish cast, by the 
constant use of the betel and areca nut. 
But not content with changing the natu- 
ral form and colour of their teeth, many 
savage tribes try to make an alteration 
in the very shape of their mouths 5 and, 
by this means, the inhabitants of Prince 
^Viiliam's Island, in the South Seas, 
appear at a distance to have two mouths. 
In order to do this, an incision is made 
in the under lip, in a line with the mouth, 



180 

sufficient to admit the tongue to pass 
through it, which, after being healed, 
continues to have all the appearance of 
lips. This artificial mouth is adorned 
with a shell, which is so cut, as to re- 
semble a row of teeth. 

These circumstances all conspire to 
prove, that the importance of the teeth is 
equally appreciated by all nations. 

In civilized society, their care is re- 
garded as a matter of fashion and orna- 
ment; and among the ruder nations, their 
preservation and cleanliness are enjoined 
as a religious duty, and their value so 
highly rated, as even at times to be 
offered in sacrifice to their deities. 

Lavater has carried his whimsical sys- 
tem so far, as even to form from the 
teeth ideas of character in the brute 
creation. To the sea-horse, from the 
structure of his teeth, he gives the dis- 
position of foolish, self-destructive ma- 
lignity. To the sheep, he gives the 
character of little or no wildness, from 



181 

the line of the mouth, or form and posi- 
tion of the teeth. But, as we have al- 
ready stated, it is not in the teeth, but on 
the countenance the great lines of charac- 
ter are exhibited. This is the theatre 
on which the soul delineates itself, and 
where the muscles of the face give it the 
expression of the inward workings of 
the mind. That countenance, which can 
at one moment display the most savage 
ferocity, or the greatest stupidity, will, 
on other occasions, exhibit the greatest 
meakness and placidity; and in all these 
circumstances, the teeth suffer no change. 
How unjust then to characterize all those 
who have irregular teeth, as possessing 
the most malignant passions ; or to ex- 
clude from our friendship, all who have 
long and separated teeth, lest they should 
rob and murder us. 

But though the teeth can have no in- 
fluence in the elucidation of character, 
yet, in regard to appearance, their influ- 
ence is great. No face can be consi- 



183 

dered as truly beautiful, which is dis- 
figured by foul, unsound, or irregular 
teeth. The laugh, which is the test of 
good humour and openness, excites only 
disgust, where the mouth exhibits foul- 
ness and deformity. A pleasing coun- 
tenance naturally prepossesses, but it 
never can be complete, unless beauty 
and regularity of the teeth unite in the 
attraction; so that where a person 
wishes to please, the care of the teeth 
forms an essential consideration : and 
hence, with justice, Lavater observes, 
that the form, position, and cleanliness 
of the teeth, so far as depends on the 
individual himself, is a certain proof 
of his taste in other matters. 



483 



CONCLUSION ; 



DOMESTIC ADVICE 



ON THE 



TEETH. 



HAVING considered, at considerable 
length, the evolution, progress, and dif- 
ferent diseases of the teeth ; it only re- 
mains to point out to parents and guar- 
dians, how much the future health and 
beauty of their charge depend on their 
attentively watching over the changes 
that take place at different periods, in 
this part of the human structure. 

It is a fact well known, and which 



184 

every one's experience daily confirms, 
that few persons pass through life, with- 
out more or less inconvenience from 
diseases of the teeth. In infancy, we 
have seen that their formation and 
growth is the source of great and con- 
stant anxiety to the fond parent ; and 
that they produce deviations from health, 
which often continue for the remainder 
of life ; for, at that early period, con- 
stitutional diseases arc called into action 
by the irritation of dentition, which 
would otherwise have remained dor- 
mant 

But that period of childhood at which 
the temporary teeth begin to shed, is 
the critical time that calls for the atten- 
tion of parents ; for, by neglect at that 
time, irregularities are, as we have seen, 
apt to arise, which might easily have 
been prevented by proper care, and a 
due attention to cleanliness of the mouth. 

The chief deformities produced by ir- 
regular teeth, are the rabbit mouth and 



185 

the projecting chin. But these and all 
other defects, may be prevented by time- 
ly attention. 

The rabbit mouth is caused by a pre- 
ternatural projection of the front teeth 
in the upper jaw, accompanied by a de- 
formed irregularity in their arrange- 
ment ; as exhibited at figure 1, in the 
frontispiece. 

The projecting chin chiefly arises from 
a casual irregularity in the protrusion 
of the front teeth in the under jaw, 
which assumes an unnatural projection, 
while those of the upper jaw do not ad- 
vance sufficiently forward, the direction 
of their points when in contact being 
contrary to what nature intended ; for 
the incisores of the upper jaw are within, 
or on the inside of those of the under, 
instead of standing out beyond them $ as 
shewn at figure 3, in the frontispiece. 

In proportion as the teeth grow, the 
deformity becomes increased and more 
conspicuous ; and so disagreeable is it, 



186 

that Physiognomists have attached to it 
a hrutal disposition. 

This instance is sufficient to shew, 
how much depends on domestic atten- 
tion ; for teeth that are too prominent 
or irregular, can always, by pressure 
made at an early period, be brought into 
their proper arrangement ; so that it is 
not the means of cure that are wanting, 
but inclination in those concerned to ap- 
ply them. That disagreeable appearance 
termed the rabbit mouth, is always in 
the power of the dentist to rectify ; and 
what parent, who has a regard for the 
personal appearance of their offspring, 
would allow such a deformity to exist. 

It is a truth, which most persons will 
admit, that before they have arrived at 
the years of maturity, disease has com- 
menced in their second or permanent 
teeth ; and it is for this reason they are 
induced to believe that the teeth are 
more easily destructible than the rest of 
the frame. 



187 

But this, we have endeavoured to 
prove, is a gross mistake ; and that, on 
the contrary, the commencement of the 
diseases of the teeth arises, from a want 
of that early and habitual cleanliness 
which is the only means, as we have al- 
ready pointed out, of preserving them. 

This we have seen confirmed in the 
cases of the African and Indian, who> 
from constant care, preserve their teeth 
in perfect health. 

Nothing, therefore, is required to ren- 
der this part of the human structure less 
destructible than any other; but the 
same attention, which, from personal 
delicacy and fashion, is paid to cleanli- 
ness of the face and arrangement of the 
hair. 

Nor should the teeth themselves btf 
the only objects of care, the gums, or 
envelope which surrounds them, de- 
mand equal attention ; and the character 
of a healthy state of the gums should be 
known to every mother. These cha- 



188 

racters are — a vermillion, or red colour 
—a close texture — their firmly embrac- 
ing the necks of the teeth — and the gum 
forming projections in every interstice, 
and receding in front, so as to surround 
each tooth in the form of a small arch. 

Where the gums, on the contrary, are 
pale and rough, their texture loose and 
flabby, and no adhesion takes place to 
the necks of the teeth, which are partly 
laid bare, it is but too apparent, that 
want of cleanliness and neglect have long 
existed, and disease of the teeth must 
already have occurred, or will soon 
follow. 

To guard against this state, the early 
management of the teeth becomes the 
duty of the mother. As soon as the 
child is weaned, the task of cleaning the 
teeth should commence; every night 
and morning the mouth of the child 
should be washed, or rinsed out with 
warm water, the tongue wiped clean 
with a cloth, the teeth gently brushed, 



189 

and the waxed thread passed between 
them. This practice, so healthy and so 
conducive to comfort, will not only pre- 
vent all disease of the teeth and gums, 
but will also extend its beneficial effects 
in promoting the absorption of the fangs, 
and securing a regular arrangement to 
the future set. 

Children, under such management, 
will be less subject to catarrhal affec- 
tions, and sore throat, by the secre- 
tions of the mouth and throat proceed- 
ing in a regular and uninterrupted man- 
ner. 

There is nothing which, in an after 
period, is so destructive to the health of 
teeth as the use of tooth-picks. They 
are usually formed of hard materials, 
and their insinuation between the teeth 
detaches the gums from their adhesion ; 
and by laying the necks of the teeth 
bare, hollows or cavities are formed, 
which afford lodgements for the food, and 
proves a certain source of disease, and 



190 

the commencement of caries. The na- 
tural character of the gum is thus de- 
stroyed, their arched appearance va- 
nishes and becomes flat, and inflamma- 
tion succeeds. 

The use, therefore, of tooth-picks is 
to be strongly condemned, whatever 
their form, or the materials of which 
they are made, and are as improper for 
children as for adults. When a pin is 
substituted, it is even more injurious 
than any other substance ; for, by the 
w r ounds it makes, if the teeth are neglect- 
ed, and tartar is allowed to accumulate, a 
putrid matter is inoculated into the gum, 
which renders it unhealthy and dis- 
eased. 

We have already recommended the 
tongues of children to be cleaned with a 
towel, the same should be continued at 
every period of life, instead of the com- 
mon instruments, termed tongue-scra- 
pers, from the frequent use of which, 
and their mechanical operation on this 



m 

part, which naturally possesses great 
sensibility, much irritation is excited, 
and the organ becomes gradually injured, 
which lessens the powers of feeling, 
and thus destroys in a certain degree 
the sense of taste. 

Nor is the use of tooth powders, 
though so much recommended, to be re- 
garded in a more favourable light. In 
♦the manner in which they are employ- 
ed, by acting on the periosteum, they 
detach and destroy that part of it which 
immediately surrounds the necks of the 
teeth, and thus occasions the loss of this 
useful and ornamental part of the human 
structure. 

The same objection applies even to 
the constant use of tooth brushes, unless 
properly adapted, in their dimensions, 
to the corresponding dimensions of the 
teeth. This is a subject of very great 
importance, and has never been suffi- 
ciently or scientifically reflected on by 
dentists, consequently the rules they 



192 

Jiave laid down for their use, have been 
highly erroneous, and often attended 
with injury, instead of answering any 
beneficial effect. It is clearly intended 
that a brush should only be applied to 
the surface of the tooth in order to re- 
move tartar or other accumulation, but 
if it is made of such a size as to proceed 
further, it rubs upon the periosteum or 
investing membrane of the teeth; and 
thus, if daily used, cannot fail to destroy" 
it, and the sooner if armed with tooth 
powder. This will shew the necessity 
for every person making a choice of a 
particular tooth brush for himself, se- 
lecting it according to the size of his 
teeth. 

When children begin to shed their 
teeth, if irregularities form in their ar- 
rangement by over-lapping each other, 
a frequent inspection should take place; 
for all deformity can at that time be 
easily rectified, nor indeed is a cure of 
any deformity to be despaired of under 



193 

the age of fifteen. In bringing irregu- 
lar teeth into their proper situation, it 
will be always preferable to extract one 
1ooth, in order to give room for the rest, 
instead of using the file, which can ne- 
ver allow of so complete and natural an 
arrangement. 

The most frequent and dangerous dis- 
ease of the teeth, we have stated to be 
caries; this affects them at a very early 
period j indeed it is often coeval with 
their first irruption, particularly when 
dentition is slow, for then the accumu- 
lated matter is apt to lodge on their 
edges, and unless carefully removed* 
disease is entailed for life. 

In every family, it should be a rule to 
have the teeth of children frequently 
inspected by a dentist; but there is an 
unfortunate prejudice entertained by 
parents, that his operations tend to in- 
jure the teeth. On this account, the 
proper time is often neglected, which 
occasions deformity and disfiguration of 



194 

the countenance for life. In many public 
seminaries this practice has been lauda- 
bly followed. It will always prevent 
much future pain and regret; and chil- 
dren, when they attain the age of reason 
and reflection, will be more grateful for 
this attention, than for those accom- 
plishments or indulgences which have 
no connection with health and comfort. 
The first traces of disease in the teeth 
are always unknown to the patient. 
Caries, in particular, is so insidious in its 
attack, that its existence often requires 
the most minute inspection of the den- 
tist's eye to detect. 

Whatever neglect may attach to the 
conduct of dentists in general, the one 
so commonly imputed to them, of dis- 
missing their patients without the neces- 
sary instruction for preserving their 
teeth in the state of order to which they 
have been restored, is one, for which 
they certainly are not responsible. Why 
should they be blamed for withholding 



195 

that information of which they were 
never in possession ? It being a fact, the 
public decision can sufficiently establish, 
that an attention to the interstices of the 
teeth, so much the object of the present 
work to recommend, is an improvement 
in the professional practice, which has 
hitherto wholly escaped their attention. 
The regular use of my dentifric appa- 
ratus, will however render any further 
instructions from the dental operator 
perfectly unnecessary. 

Most dentists have an opinion that the 
teeth are sometimes too close to each 
other. But this can never be the case; 
for, in the closest set, there will be always 
room sufficient to pass the waxed thread 
in their interstices, provided there be no 
tartar to prevent it. Close teeth, on the 
contrary, have the advantage of afford- 
ing a greater support to each other, and 
of causing a more general and firmer 
adhesion of the gum. 

Among the popular prejudices which 



196 

Lave been sanctioned by dentists, is that 
of bad teeth being hereditary or running 
in families. This is a most erroneous 
idea, and ought to be strongly combated, 
as under such a prepossession the teeth 
will generally be neglected. Parents 
supposing that every means used for the 
prevention of disease will be fruitless. 

I have no hesitation in affirming, that 
bad teeth are always accidental, and are 
to be considered either as the conse- 
quences of neglect, or improper manage- 
ment. This is confirmed by the appear- 
ance of the teeth in all animals but man ; 
in the former we discover no diseased 
structure or other deformity, and there- 
fore we are induced to ascribe it to for- 
tuitous, not constitutional or hereditary 
causes. In favouring this opinion, den- 
tists seem little aware how materially 
they injure themselves, and the discredit 
that is reflected on their own profession. 

The use of the tooth brush we for- 
merly stated, as only injurious when not 



197 

adapted to the size of the teeth, and 
acting too powerfully on the gums. 
With attention to this regulation, brush- 
ing the teeth is a most healthy and 
useful operation, provided no tooth pow- 
der is used, otherwise the ingredients 
of which it is composed will be liable to 
insinuate between the gum and perios- 
teum, producing irritation and all its 
consequences. The period of shedding 
the first teeth, we haVe stated as the cri- 
tical time for insuring to them regularity 
of arrangement, and beauty of appear- 
ance. It is at this time, the care of the 
dentist becomes indispensable, that the 
primary teeth, whose fangs are not ab- 
sorbed, may be removed in time to pre- 
vent the permanent teeth acquiring any 
deformity, as well as to secure symmetry 
to the countenance, and harmony to the 
features. 

The above observations have been 
dwelt on thus earnestly, from a wish to 
impress upon parents their serious im- 



193 

portance, to secure them from falling 
into improper hands, and to induce 
them to follow a system founded on rea- 
son and experience, eminently calcu- 
lated for promoting the beauty and 
health of the human structure. 



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the Geological Society of London, &c. &c- 
from the eighth London edition, greatly 
enlarged, and carefully adapted to the pre- 
sent state of Chemical Science. 1 vol. 8vo. 
Price S 3 50, bound. 

14. 
THE MODERN PRACTICE OF PHY- 
SIC, exhibiting the characters, causes, symp- 
toms, prognostics, morbid appearances, and 
improved method of treating the diseases of 
all climates. By Robert Thomas, M. D. of Sa- 
lisbury, England. The fourth American 
from the fifth London edition, revised, and 
considerably enlarged, by the Author. With 
an appendix by David Hosack, M. D. F. R. S. 
one large volume, 8vo. Price g4 50, bound. 

15. 
JOHN AND CHARLES BELL'S ANA- 
TOMY OF THE HUMAN BODY, illus- 



•Yew Works, Sfc. by Collins Sf Croft. 

tinted by 125 Engravings. In 3 volumes. 
Price 11 Dollars. — The London Edition of 
this highly important work sells at 24 Dol- 
lars, although the Engravings are not so well 
executed as those of the American Copy. 

Of the character of Bell's Anatomy, it may not 
become the publishers to say any thing. The fol- 
lowing extract will satisfy every enquirer : — 

4< It would be injustice to confound this work 
with the ordinary compilations from the common 
stock of elementary writers, and the transcribed 
lectures of the Class Room. It is obviously the re- 
sult of very extensive study, both in books and in 
the Dissecting Room, and its completion now sup- 
plies a want very much felt by the English reader." 
AikitiLS Annual Review, 

16. 

A TREATISE ON SURGICAL DIS- 
EASES, and the Operations suited to them, 
by Baron Boyer, member of the Legion of 
Honour, Professor of Surgery of the Faculty 
of Medicine of Paris, Principal Adjunct sur- 
geon of the Hospital de la Charite, Member 
of several National and Foreign learned So- 
cieties, &c. &c. Translated from the French 
by Alexander H. Stevens, M. D. Professor 



New Works, Sfc. by Collins Sf Croft. 

of the Principles and Practice of surgery in 
the Medical Institution of New York, and of 
Queen's College, New-Jersey; one of the 
Consulting Physicians of the New York Dis- 
pensary, &c. with Notes, and an Appendix, 
by the Translator. 

The Proprietors and Publishers cannot more 
properly introduce this Translation of Boxer's 
Surgery than by adopting 1 the declaration of the 
Translator, which is subjoined. 

" The character of Baron Boyer, as a practical 
Surgeon, and as a Surgical Writer, is without rival 
on the Continent of Europe. His work on the 
Bones, which was long since translated into English 
is justly ranked among the Medical Classics. The 
high encomiums that have been bestowed upon 
these volumes, and the want of a comprehensive 
System of Surgery adapted to modern practice, 
sufficiently explain the translator's motives in of- 
fering this work to the public. In the translation, 
conciseness and perspicuity have been aimed at, 
and four volumes of the original are compressed in- 
to two. The author's motives in preparing this 
system of surgery, are illustrated by the following 
short extract from his Preface. • After having 
practised Surgery more than four and twenty years, 
I might easily have confirmed each precept by 
cases which have occurred to me ; but fearing to 



JVcw Works, Sfc. by Collins Sf Croft. 

render my work too voluminous, I have related on- 
ly such cases as appeared to me to present some 
remarkable peculiarity of novelty and utility.' " 

17. 
INNES'S SHORT DESCRIPTION OF 
THE HUMAN MUSCLES, arranged as 
they appear on Dissection, together witli 
their several uses, and the synonyma of the 
best authors ; an improved edition, with 17* 
engravings, 12mo. Price $ 1 50. 

18. 
BARD'S COMPENDIUM OF MID- 
WIFERY; the management of Women 
during Pregnancy, in Labour, and in Child- 
bed, illustrated by many cases, and particu- 
larly adapted to the use of students. Fourth 
edition, enlarged. By Samuel Bard, M. D. 
L. L. D. president of the College of Physi- 
cians and Surgeons in the University of the 
State of New York. 1 vol. 8vo. Price § 3. 












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